Flat foot is quite a common condition of the foot, but most of the time merely having a lower arch or flatter foot is not necessarily alway going to be 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 progressively lower and the heel 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 uses a lot of effort resulting in a lot of tiredness.
The explanation for posterior tibial tendon dysfunction is not really fully understood, however it is an issue in which the posterior tibial tendon and muscle can not just do the job that it is designed for. The main role of the posterior tibial tendon is to hold up the arch of the foot and stop the rearfoot rolling inwards. For some reason the muscle and tendon unit can not just do that task any more, leading to the progressive nature of this condition.
The treatment of posterior tibial tendon dysfunction is almost urgent and really should be dealt with as early as it possibly can. This is due to the condition is progressive and it will get to a point where conservative interventions don’t work and surgery is the only option. As the surgical outcomes are usually satisfactory, they do include the fusion of some joints to stop the disorder getting worse, that does have some long term restrictions on gait and function, so is best avoided. To avoid the surgical option, treatments ought to be started early. This will involve foot supports that are really supportive and angle the foot back in the correct position. Exercises are also encouraged, but should never be used instead of foot orthotics, as they are important to stop this problem from getting worse.