Flat foot is a fairly common condition of the foot, but most of the time merely having a lower arch or flatter foot is not necessarily a problem. What is a concern is if it is progressive and becomes painful, then it is known as posterior tibial tendon dysfunction or adult acquired flatfoot. In these cases the arch of the foot becomes gradually lower and the rearfoot rolls inwards. This is usually followed by pain in the arch of the foot and in the ankle area. Those with this also find walking is a lot more difficult and walking consumes a lot of energy resulting in a lot of fatigue.
The cause of posterior tibial tendon dysfunction is not really fully understood, but it is a problem in which the posterior tibial tendon and muscle can not just do the task that it is intended for. The main role of the posterior tibial tendon is to support the arch of the foot and prevent the rearfoot rolling inwards. For reasons unknown the muscle and tendon unit can not just do that job any more, leading to the progressive nature of this condition.The treatment of posterior tibial tendon dysfunction is somewhat urgent and needs to be addressed as early as it possibly can. This is due to the disorder is progressive and it will reach a point where non-surgical interventions do not work and surgery is the only alternative. As the surgical outcomes usually are satisfactory, they do involve the fusion of some joints to prevent the condition getting worse, that comes with some long term limitations on gait as well as function, so is best avoided. In order to avoid the surgical option, treatment options should be started early. This will consist of foot orthotics that are very supportive and position the foot back in the right position. Exercises are also recommended, but should not be used instead of foot supports, as they are vital to stop this problem from getting worse.