POSTERIOR TIBIAL TENDON DYSFUNCTION
(ADULT FLAT FOOT WITH DEFORMITY)
By: Robert H. Sheinberg, D.P.M., D.A.B.F.A.S., F.A.C.F.A.S.
Progressive lowering of the arch secondary to weakness or tearing of the tendons and ligaments that support it.
- Inflammation of a tendon on the inside of the ankle and foot.
- Weakening of the ligaments supporting the arch.
- Connective tissue disease (i.e. rheumatoid arthritis, psoriatic arthritis).
- Trauma to the foot or ankle (inner ankle sprain).
- Flatfoot deformity that progresses with time.
- Swelling inside the ankle and foot.
- Lowering or flattening of the arch (flatfoot).
- Bulging of the bones on the inside of the ankle and foot.
- Foot points excessively to the outside and starts to deform.
- Pain with walking even short distances.
- Stiffness of the foot and ankle that does not resolve.
- Weakness of the muscles and ligaments supporting the arch.
- Bunions, hammertoes.
- Back pain and knee pain.
- Tight Achilles tendon.
- Diabetes, hypertension and obesity.
- Supporting the foot and ankle with braces and orthotics (custom shoe insoles).
- Immobilization in a cast or boot to allow the tendon and ligaments to heal.
- Physical therapy to improve muscle strength, flexibility and overall balance.
- Anti-inflammatories to decrease inflammation.
- Surgery to reconstruct the arch and prevent further damage if the condition has not improved.
- If treated early, the deformity and its progression can be minimized.
- In more moderate cases surgical stabilization of the foot will allow a return to activities.
- In severe cases surgical reconstruction of the arch will allow the person to return to many activities.
Pics and X-rays of End Stage Adult Acquired Flatfoot after PT rupture 7 years ago.
Due to the severity of the foot collapse, the ankle joint is beginning to tilt (ankle valgus).