Adult Acquired Flatfoot Deformity

Have you noticed your feet getting flatter? Are you having arch pain? If so you might have a condition call Adult Acquired Flatfeet or Posterior Tibial Tendon Dysfunction. The medial arch of your foot acts as a shock absorber, controlling forces throughout your gait. The main tendon that controls the arch is called the posterior tibial tendon. Due to injury or abnormal bone and joint architecture, the tendon may develop tears or even rupture. As the tendon weakens, the arch collapses. Long term collapsed arches leads to wear and tear arthritis to the surrounding joints causing even more pain and a rigid flat foot. Severe cases may cause ankle arthritis.




Common symptoms include pain and swelling along the inside ankle and arch as well as progressive flattening of the feet. You may also have along the outside of the foot near the ankle. Along with flat arches, the foot may splay out. Another sign is uneven shoe wear.




Mild cases will have pain without flattening of the arch. This typically responds well with bracing, rest, and custom molded orthotics. As the condition worsens with flattening of the arch; conservative treatment as with mild cases is first line treatment.


An MRI may be ordered to check the condition of the tendon. If the pain does not respond to conservative treatment or if the MRI shows a tear or rupture of the tendon then surgical treatment with a flatfoot reconstruction is indicated. Severe cases will have chronic pain with flat arches that is rigid. These cases typically have arthritis to multiple joints in the foot. Treatment may include cortisone injections but typically these severe cases require surgery to fuse the damaged joints and relieve pain.


If you have painful flat feet, make an appointment with the Foot and Ankle Specialists at Advanced Foot & Ankle Center. Offices conveniently located in Mckinney and Prosper TX.