WHAT IS IT?
This dysfunction is commonly known as PTTD or flatfoot. It is one of the most common problems of the foot and ankle.
WHAT CAUSES IT?
The posterior tibial tendon provides support and stability for the arch of the foot. When this tendon becomes torn or inflamed, it results in a fallen arch, hence the flatfoot term. The posterior tibial tendon is a major supporting structure of the foot, which aids with walking and most activities. Overuse of this tendon during activities such as walking, long distance running, hiking and climbing stairs are all contributing factors to development of PTTD.
SYMPTOMS
- Pain, swelling and inflammation at the instep of the foot.
- Flattening of the arch of the foot.
- Inability to stand for long on the balls of your feet (heel raise).
- An inward rolling of the ankle towards the ground.
- The arch of the foot collapses completely at later stages. This is seen by a complete inward roll of the ankle, with the toes pointing outwards.
- In advanced stages, the pain shifts from the instep towards the outside of the foot. Arthritis can also develop.
TREATMENT
PTTD has a progressive nature. To prevent further progression of the dysfunction, it should be treated very early.
- Orthotic devices can be customized by your foot and ankle surgeon to fit into your shoes.
- Immobilization such as wearing a boot may be necessary to prevent strain on the tendon and remove any weight bearing activities.
- Physiotherapy exercises can be done to strengthen the surrounding tendons to help with the role of the weakened tendon.
- Corticosteroid shots.
- Anti-inflammatory medications for pain.
- Special shoe inserts may need to be worn to adjust to your fallen arch.
Once the condition had progressed significantly, surgery will be recommended. Your foot and ankle surgeon will give you’re the best options.