Flat foot is a pretty common disorder of the foot, but most of the time merely having a lower arch or flatter foot is not necessarily an issue. What is a issue is if it is progressive and becomes painful, then it is called posterior tibial tendon dysfunction or adult acquired flatfoot. In these cases the arch of the foot becomes gradually flatter and the rearfoot 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 consumes a lot of effort leading to lots of fatigue.The reason for posterior tibial tendon dysfunction is not totally, but it is an issue where the posterior tibial tendon and muscle can not just do the task that it is intended for. The principal role of the posterior tibial tendon is to hold up the arch of the foot and prevent the heel rolling inwards. For some reason the muscle and tendon complex can not just do their task any more, resulting in the progressive nature of this problem.
The treatment of posterior tibial tendon dysfunction is almost urgent and ought to be dealt with as soon as it possibly can. The reason being the disorder is progressive and it will get to a point where conservative measures don't work and surgery is the only option. Even though the surgical outcomes are generally satisfactory, they do include the fusion of some joints to prevent the problem getting worse, that does have some long term limitations on gait as well as function, so is best avoided. In order to avoid the surgical treatment, treatment options must be started early. This will likely involve foot supports that are very supportive and position the foot back in the right position. Exercises are also suggested, but should never be used rather than foot orthotics, as they are important to stop this problem from getting worse.