Flat foot is a fairly common condition of the foot, but most of the time simply having a lower mid-foot (arch) or flatter foot is not always a problem. What is a concern is if it is progressive and becomes painful, then it's referred to as posterior tibial tendon dysfunction or adult acquired flatfoot. In these cases the arch of the foot becomes gradually flatter and the heel rolls inwards. This is usually accompanied with pain in the arch of the foot and in the ankle region. Those with this also find walking is a lot is a lot and walking consumes a lot of energy leading to lots of tiredness.The explanation for posterior tibial tendon dysfunction is not really fully understood, however it is an issue in which the posterior tibial tendon and muscle are unable to just do the job that it is intended for.

The key role of the posterior tibial tendon is to support the arch of the foot and stop the heel rolling inwards. For reasons unknown the muscle and tendon unit can't just do that task any more, leading to the progressive nature of this disorder.The treatment of posterior tibial tendon dysfunction is almost urgent and really should be dealt with as early as it possibly can. The reason being the disorder is progressive and it will reach a point where conservative methods are unsuccessful and surgery is the only choice. As the surgical outcomes are in general acceptable, they do involve the fusion of some joints to stop the problem getting worse, that comes with some long term limitations on gait and function, so is best avoided. To prevent the surgical treatment, treatment options must be started early. This will likely consist of foot supports that are really supportive and angle the foot back in the correct position. Exercises are also encouraged, but should not be used rather than foot supports, as they are important to stop the flat foot from getting worse.