The tight muscle and tendon bring the heel off the ground too early with each step. Tight Achilles tendon and/or calf muscle are also a risk factor for flat feet. Any injury to this tendon, which runs on the arch side of the ankle and foot, can affect its ability to maintain an arch in the foot and can result in a flat foot.
The posterior tibial tendon creates the arch and supports the foot when you push off your toes when walking and running. In the case of a flexible flat foot that is not due to a posterior tibial tendon tear, support of the arch with insoles, orthotics, and rigid-soled shoes will decrease the strain on the posterior tibial tendon and decrease the risk of further and permanent arch collapse due to tendon tear.įlexible flat foot is often caused by posterior tibial tendon dysfunction. The deformity in flexible flatfoot involves a mild, gradual collapse of the foot’s arch, and almost always occurs in both feet. In many cases of flat foot that is not worsening over time and is on both feet problem originates in childhood and lasts throughout adulthood, typically worsening without treatment. It is important to treat a flexible flat foot due to posterior tibial tendon tear rapidly prior to the joints becoming rigid due to the severe collapse. Over time, the collapsed arch may go from flexible to rigid as the foot gets “stuck” in the flat position and therefore is not freely reducible and correctable. With a tear in the tendon over many years of abnormal strain, the arch will begin to collapse as the posterior tibial tendon weakens and unravels. This is due to damage to the posterior tibial tendon which is the main tendon supporting the arch of the foot. Adult acquired flat foot is not a congenital flat foot but acquired over time.
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