Flat foot is a pretty common condition of the foot, but most of the time merely having a lower arch or flatter foot is not necessarily an issue. What is a concern is if it is progressive and becomes painful, then it's called posterior tibial tendon dysfunction or adult acquired flatfoot. In such cases the arch of the foot becomes progressively flatter and the rearfoot rolls inwards. This is usually associated with 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, but it is a problem where the posterior tibial tendon and muscle can not just do the job that it is intended for.
The main role of the posterior tibial tendon is to hold up the arch of the foot and stop the heel rolling inwards. For some reason the muscle and tendon unit are unable to just do that job any more, resulting in the progressive nature of this disorder.The treatment of posterior tibial tendon dysfunction is sort of urgent and needs to be addressed as early as it possibly can. The reason being the condition is progressive and it will get to a point where conventional methods don't work and surgery is the only choice. Even though the surgical outcomes are likely to be satisfactory, they do include the fusion of some joints to prevent the problem getting worse, that does have some long term restrictions on gait and function, so is best avoided. In order to avoid the surgical intervention, treatments needs to be started early. This will likely involve foot supports that are very supportive and angle the foot back in the correct position and help improve ths posterior tibial tendon dysfunction. Exercises are also suggested, but should not be used instead of foot supports, as they are important to stop the flat foot from progressing.