Acquired Adult Flatfoot Symptoms and Treatment

Acquired Adult Flatfoot Overview

Acquired adult flatfoot is also known as Posterior tibial tendon dysfunction (PTTD). The posterior tibial tendon serves a vital function in the biomechanics of the foot and pathology of this tendon can lead to debilitating pain and possibly arthritis of foot and ankle.

Acquired adult flatfoot is a condition where the tendon has gone through changes, which makes it unable to support the arch of the foot, resulting in flattening of the foot. Posterior tibial tendon dysfunction is the most common cause of flat feet in adults, hence “adult acquired flatfeet”. This condition can happen in one foot or both feet and in general it tends to be progressive in nature, especially if it is not treated early.

Signs and symptoms of acquired adult flatfoot

    • Loss of arch height
    • Swelling to medial ankle (along the course of the tendon)
    • Inability to rise on the toes (single heel raise)
    • Pain to medial ankle with weight bearing
    • Lateral foot pain (sinus tarsi pain)
    • Inward rolling of the ankle
    • Toes starting to point towards the outside


Causes of Acquired Adult Flatfoot

    • Overuse
    • Not wearing supportive shoes
    • Foot sprain / trauma
    • Engaging in activities that involves the tendon: running, walking, hiking and climbing


Imaging of Acquired Adult Flatfoot:

MRI may be a valuable tool in evaluating the integrity of the tendon

Non-surgical Treatment of Acquired Adult Flatfoot

Acquired adult flatfoot is progressive and early evaluation and treatment of this condition is strongly advised. If treated early enough, your symptoms may resolve without the need for possible surgical intervention.

In contrast, untreated acquired adult flatfoot could leave you with an extremely flat foot, painful arthritis in the foot and ankle, and increasing limitations on walking, running, or other activities.

In many cases treatment can begin with non-surgical approaches that may include:

  • Immobilization. Sometimes a short-leg cast or boot is worn to immobilize the foot and allow the tendon to heal, or you may need to completely avoid all weight-bearing for a while shopping cart
  • Orthotic devices or bracing. Orthotics or Ankle Foot Orthosis (AFO) to support the arch and decrease tension on the tendon. shopping cart
  • Physical therapy. Ultrasound therapy and exercises may help rehabilitate the tendon and muscle following immobilization.
  • Medications. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, help reduce the pain and inflammation.
  • Shoe modifications. Your foot and ankle surgeon may advise you to change your shoes to something more supportive. (Please refer to our comprehensive shoe list to find the appropriate shoe based on you foot type)
  • Topical pain relieving gel for sore feet shopping cart


When Is Surgery Needed Acquired Adult Flatfoot?

In advanced progression or failed conservative treatment of acquired adult flatfoot, surgical intervention may be required to address your pain and foot deformity.

We encourage you to consult with a foot and ankle specialist for a complete assessment of your condition.


acquired adult flat foot