What is it?
A painful flat foot, or adult acquired flatfoot deformity, is a progressive collapsing of the arch of the foot that occurs as the posterior tibial tendon becomes insufficient due to various factors. Early stages may present with only pain along the posterior tibial tendon whereas advanced deformity usually results in arthritis and rigidity of the rearfoot and ankle.
Posterior tibial tendon dysfunction is the most common cause of acquired adult flatfoot. Sometimes this can be a result of specific trauma, but usually the tendon becomes injured from wear and tear over time. This is more prevalent in individuals with an inherited flat foot but excessive weight, age, and level of activity are also contributing factors.
Depending on the stage of the deformity and patient’s functional goals, various treatment options are available. Some patients improve with conservative care which includes rest and immobilization, shoe modifications, orthoses and bracing, or physical therapy. Surgery might be warranted for advanced stages of the condition. Often a combination of procedures including tendon and muscle augmentation, tendon transfers, realigning of bones or fusion of certain joints might be necessary in more advanced cases. Your doctor will evaluate and recommend an individualized plan of care with your specific needs in mind.