Posterior tibial tendon dysfunction is the most common cause of adult acquired flatfoot. Effectively what happens in this condition is that the posterior tibial muscles just literally gives up and can no longer do its job of providing a supinatory moment to the subtalar joint. As a result of this the foot progressively becomes more and more pronated and flatter. Accompanying this progressive deformity is increasing pain and disability. If posterior tibial tendon dysfunction is not caught early enough, it can become quite disabling and have a significant impact on quality of life. Treatment is always needed as it won’t stop progressing on its own and the sooner it is started the better, as it will progressively get more difficult to manage as it progresses. In the early stages, very rigid orthotics are needed or the foot orthotics will fail. The forces needed to supinate the foot in these with posterior tibial tendon dysfunction (PTTD) is so high, that something soft will just flatten out. If you not sure about, this just try and supinate the foot by lifting up the arch with your fingers. If the progressive posterior tibial tendon dysfunction is not caught early enough, then surgical options are really all that is available.

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