An acquired flatfoot is attributed to dysfunction of the posterior tibial tendon. However the development of this deformity can be influenced by multiple causes to include:

• ligamentous structures of the foot and ankle

• Obesity

• Previous trauma

• Corticosteroid injections

• Arthritis

• Neuromuscular conditions

Symptoms range from person to person and often follow a sequential pattern.

• Pain & Discomfort: In the arch, heel, or along the inner ankle.

• Swelling: Along the inside of the ankle/foot.

• Fatigue: Feet feel tired or achy, particularly after standing or walking.

• Gait Changes

• Difficulty with Movement

• Uneven Shoe Wear: Shoes wear down on the inside edge. 

Treating progressive collapsing foot deformity is complex and patient dependent

Conservative Treatment

• Orthotic devices, articulating ankle-foot orthosis, bracing

• “RICE” Rest, Ice, Compression, Elevation

• Reduction of activity levels.

• Oral medications

• Shoe gear changes

• Immobilization

Physical therapy

Surgical treatment is indicated in patients who have failed conservative therapy. Surgical treatment depends on the stage of the disease and other factors, including medical comorbidities, functional status, and use of tobacco.

• Soft tissue procedures

  • Tendon debridement,

  • Repair of the posterior tibial tendon

  • Tendon transfer

  • Ligament repair

  • Tendon lengthening

• Bony procedures

  • Osteotomies

  • Arthrodesis Foot/Ankle

  • Ankle Arthroplasty