Flat foot is a pretty common condition of the foot, but most of the time simply having a lower mid-foot (arch) or flatter foot is not always a problem. What is a problem is if it is progressive and becomes painful, then it’s referred to as posterior tibial tendon dysfunction or adult acquired flatfoot. In these cases the arch of the foot becomes steadily flatter and the rearfoot rolls inwards. This is usually associated with pain in the arch of the foot and in the rearfoot area. Those with this also find walking is a lot more difficult and walking uses a lot of energy resulting in lots of fatigue.
The explanation for posterior tibial tendon dysfunction is not totally understood, however it is a problem where the posterior tibial tendon and muscle can’t just do the task that it is intended for. The principal role of the posterior tibial tendon is to support the arch of the foot and prevent the rearfoot rolling inwards. For some reason the muscle and tendon unit are unable to just do their task any more, resulting in the progressive nature of this problem.
The treatment of posterior tibial tendon dysfunction is almost urgent and needs to be dealt with as soon as it possibly can. This is due to the disorder is progressive and it will get to a point where conventional methods do not work and surgery is the only choice. While the surgical outcomes are generally acceptable, they do consist of the fusion of some joints to stop the condition getting worse, that comes with some long term restrictions on gait as well as function, so is best avoided. To avoid the surgical option, treatments should be started early. This will involve foot supports that are really supportive and angle the foot back in the right direction. Exercises are also encouraged, but should not be used rather than foot supports, as they are critical to stop this problem from progressing.