Understanding the Connection: Flat Foot and Posterior Tibial Tendon Dysfunction

Flat foot, or pes planus, is a common condition characterized by the lowering of the arch of the foot. While often seen as a mere anatomical variation, flat foot can lead to various complications, one of the most significant being posterior tibial tendon dysfunction (PTTD). This blog explores how flat foot can contribute to PTTD and what it means for those affected.

What is Posterior Tibial Tendon Dysfunction?

The posterior tibial tendon is a crucial structure in the lower leg that plays a vital role in maintaining the foot's arch and supporting the body's weight during walking and running. It runs along the inside of the ankle and attaches to the bones of the foot, facilitating movement and stability. When this tendon becomes inflamed or damaged—often due to overuse or improper alignment of the foot—it can lead to PTTD, which may cause pain, swelling, and significant mobility issues.

The Link Between Flat Foot and PTTD

Flat foot can significantly alter the biomechanics of the foot and ankle. Here’s how:

1. Altered Foot Mechanics: Individuals with flat feet tend to experience overpronation, where the foot rolls inward excessively during walking or running. This overpronation can place added stress on the posterior tibial tendon, leading to inflammation and dysfunction over time.

2. Increased Load on the Tendon: When the arch is lower, the posterior tibial tendon must work harder to support the foot and stabilize it during movement. This increased load can lead to microtrauma, causing the tendon to weaken and eventually succumb to dysfunction.

3. Impaired Muscle Function: Flat foot can lead to weakness in the foot and ankle muscles, particularly the muscles that support the arch. As the foot collapses, the posterior tibial tendon struggles to compensate for the lack of support, resulting in further strain and dysfunction.

4. Injury Risk: Individuals with flat feet are often at a higher risk for developing PTTD not only due to biomechanical changes but also because flat foot can contribute to other related conditions, such as shin splints or Achilles tendonitis. These can compound the strain on the posterior tibial tendon.

Signs and Symptoms of PTTD

Recognizing the early signs and symptoms of PTTD is crucial for effective intervention. They may include:

- Pain along the inside of the ankle and foot
- Swelling around the ankle
- Difficulty standing on tiptoe or performing activities that place stress on the ankle
- Flattening of the medial longitudinal arch (the arch along the inside of the foot)
- A tendency to roll the ankle inward, leading to increased instability

Preventative Measures and Treatment

If you have flat feet, there are several strategies you can adopt to help prevent or manage PTTD:

1. Footwear Choices: Invest in supportive footwear that accommodates your foot's shape and provides adequate arch support. Avoid flat shoes that lack cushioning.

2. Orthotics: Custom orthotic devices can help correct biomechanical issues and offer better support to the arch, alleviating strain on the posterior tibial tendon.

3. Strengthening Exercises: Engage in exercises that target the muscles of the foot and ankle to improve strength and stability. Exercises like calf raises and arch lifts can help maintain the function of the posterior tibial tendon.

4. Physical Therapy: Consulting a physical therapist can provide tailored exercises and treatment strategies that address both flat feet and any early symptoms of PTTD.

5. Activity Modifications: Be mindful of activities that exacerbate foot pain. Gradually increase the intensity of exercise and incorporate rest days to allow for recovery.

If you suspect you have flat foot or are experiencing symptoms of posterior tibial tendon dysfunction, schedule an appointment with Dr. Gireesh Reddy or Dr. Sirisha Pokala with Restore Foot & Ankle Specialists by calling (469) 573-3427 or by booking an appointment online.