Flat Feet and Posterior Tibial Tendon Dysfunction

Flat feet are common. And not all of them are painful. Some people are born with a flexible flatfoot and have no issues with common activities, while others were born with a normal arch but develop a flat foot over time. This is more likely related to posterior tibial tendon dysfunction, or PTTD. This condition can happen as a result of poor biomechanics, repetitive stress, age, weight, certain medical conditions or even medications you might take.  The posterior tibial tendon rarely weakens or fails all at once. It is a progressive degeneration, like we saw with the Achilles tendon in Episode 6. Repetitive stress on a weakened tendon creates a cycle that ultimately results in tendon tearing and failure, leading to collapse of the arch. At first this is a tendon only problem. Later this becomes a multi-joint failure with degeneration and adaptive changes in other structures of the foot and ankle.  Early intervention may prevent progression to the arthritic process of joint degeneration. Orthotics, physical therapy, activity and shoe gear modification are used early on. Later stages may require more aggressive treatment including surgery. Occasionally, we use surgery as a tool earlier in the process before the late stage events occur.  The content of this podcast is for educational and informational purposes only and does not constitute medical advice. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.