Adult Acquired Flat Foot (Posterior Tibial Tendon Dysfunction)One of the major tendons in the lower leg is the posterior tibial tendon, which stretches down from the calf, to the ankle, to the bones in the middle of your foot. This tendon helps hold the arches of your foot up and provides support when you're walking. Adult acquired flat foot (also known as posterior tibial tendon dysfunction or PTTD) occurs when this tendon becomes inflamed, overstretched, or torn, leading to the flattening of the foot (low arches).
Flat Foot CausesAdult-acquired flat foot occurs most often in women over the age of 50 and may be due to genetic factors. However, PTTD has also been associated with overuse of the posterior tibial tendon, obesity, diabetes, hypertension, and trauma. Athletes who have previously injured or torn their posterior tibial tendon may also be at higher risk.
Flat Foot SymptomsIn some individuals, flat foot may have no symptoms and causes no problems. However, if your flat foot is painful with prolonged standing or if your feet tire easily, then flat foot may be a problem. With PTTD, the pain may migrate to different areas of the foot as it flattens out. Usually pain starts on the inside of the foot then moves toward the outside of the foot.
Additionally, some patients may find it difficult to stand on tip toes and have tenderness over the middle of the foot, especially during physical activity. In a few patients, flat foot may also contribute to low back pain.
Treatment of Flat FootAs with any injury, your doctor will be the best source of advice on the appropriate treatment method for your situation. If flat foot does not cause you pain, treatment may not be necessary. Treatment of flat foot often starts with rest and cold therapy. Anti-inflammatory medications such as ibuprofen and aspirin can be used to bring down irritation. In some cases your doctor may also recommend physical therapy where you will learn foot stretches and strengthening exercises. A steroid injection may also be used to relieve pain.
Your doctor may also suggest orthotic shoes, insoles, or a foot brace for flat foot such as the Aircast Airlift PTTD Brace. It includes an adjustable aircell under the arch of the foot that helps shape the foot into a natural position. In cases of severe flat foot, surgery may be advised to reduce pain and improve the alignment of your bones.