Adult-acquired flatfoot, also known as posterior tibial tendon dysfunction (PTTD), is a condition that causes weakening and degeneration of the posterior tibial tendon in adults. This tendon connects the bones in your foot to your calf muscle and helps support the arch of your foot. When it weakens or tears, it can cause your arch to flatten out and your foot to become painful and unstable. Adult-acquired flatfoot is most commonly seen in people aged 40 or older, although it can affect anyone at any age.
Causes of Adult-Acquired Flatfoot
There are several potential causes of adult-acquired flatfoot. You may experience this condition because of:
- A previous foot injury or trauma
- Rheumatoid arthritis
If you have any of these conditions, it's essential to watch for symptoms of adult-acquired flatfoot.
Flatfoot Symptoms in Adults
Some common signs of adult-acquired flatfoot include:
- Swelling of the inner ankle
- Pain along the ankle that worsens with activity
- Difficulty standing or walking for long periods of time
- Difficulty standing on tiptoes
- Instability when walking or running
- Collapsed arch with your whole foot touching the floor
- Heel pain with redness and warmth to the touch
- Inward turning of the heel pain
- Bony bumps that occur on the inside or top of your foot
It's important to see a doctor as soon as possible if you experience any of these symptoms so that an accurate diagnosis and effective treatment plan can be made.
Diagnosis and Staging of Adult-Acquired Flatfoot
Your doctor will take your medical history and perform a physical examination of your foot to diagnose adult-acquired flatfoot. In some cases, your doctor may also order imaging tests such as X-rays, CT scans, or MRIs to confirm the diagnosis.
Adult-acquired flatfoot is classified into four stages that help describe the condition's severity. These classifications include:
- Stage 1. In the mildest stage, there may be some pain, inflammation, and swelling in your foot. The tendon may still be intact at this point, but it is starting to weaken.
- Stage 2. In the next stage, the arch begins to collapse as the tendon continues to stretch and weaken. There will likely be more pain than in Stage 1.
- Stage 3. This stage is marked by a further flattening of the arch and increased instability when standing or walking. Pain is still present. Arthritis may form, and the foot may become rigid.
- Stage 4. This advanced stage is marked by a severe flattening of the arch and instability when standing or walking. You may continue to experience pain.
Your stage of adult-acquired flatfoot will help your doctor decide on the right treatment plan for you.
Adult-Acquired Flatfoot Treatment
Depending on the severity of your condition, treatment for adult-acquired flatfoot may vary. Some options include:
- Lifestyle changes. Lifestyle changes may include rest and wearing supportive shoes.
- Conservative treatments. Conservative treatments, such as physical therapy, orthotics, braces, and nonsteroidal anti-inflammatory medications (NSAIDs) to reduce pain and inflammation, may help you manage your condition.
- Surgery. Surgery may be required in more advanced cases. Some examples of surgeries include tendon transfers, tendon repairs, osteotomies, and fusion of joints. Tendon transfers involve taking healthy tendons from another area of the body and attaching them to the posterior tibial tendon to help support the arch. Tendon repairs involve reattaching or repairing the damaged tendon itself. Osteotomies are used to realign bones in order to improve the alignment of your foot and ankle. Fusion of joints may be necessary if severe arthritis is present in your foot and ankle joints.
If left untreated, adult-acquired flatfoot can lead to further complications such as tendinitis, arthritis in your foot joints, and even deformity of your foot. However, with prompt medical care, adult-acquired flatfoot can be managed effectively so that you can enjoy your regular activities.
You deserve to live without the pain and complications of adult-acquired flatfoot. Please contact the Idaho podiatry team at Advanced Foot & Ankle today to schedule an appointment in our Twin Falls or Burley offices. You can request an appointment online or call us directly at (208) 731-6321.