Mr Dishan Singh MBChB, FRCS, FRCS(Orth)

Consultant Orthopaedic Surgeon, Foot & Ankle Specialist

Adult acquired flatfoot deformity or tibialis posterior tendon dysfunction

The tibialis posterior is a muscle in the lower leg. The tendon from this muscle runs behind the inside bone on the ankle (called the medial malleolus), across the instep and attaches to the bottom of the foot. The tibialis posterior is important as it helps to hold the arch of the foot up and stop the foot rolling over. Sometimes the tendon becomes stretched and inflamed. This condition can be called Tibialis Posterior Tendon Dysfunction, Tibialis Posterior Insufficiency or Adult Acquired Flat Foot.

Adult acquired flatfoot or tibialis posterior tendon dysfunction

Tibialis Posterior Tendon Dysfunction is a condition of increasing symptoms and deformity, loosely classified into four stages. Ageing leads to decreased strength of muscles, tendons and ligaments. If a person has flat feet, a greater load is placed on their tibialis posterior tendon. Over time this can cause stretching, inflammation and degeneration of the tendon, which may result in the tendon tearing. This process has a knock on effect to the arch of the foot, which may appear collapsed and the position of the bones of the foot and ankle may alter.

A tibialis posterior tendon reconstruction is usually performed for stage two symptoms, when the tendon is partially torn, there is pain and swelling, the foot is becoming flatter, it is not possible to go up on tiptoes on the foot and function is becoming limited.

Read more about adult acquired flatfoot deformity (tibialis posterior tendon dysfunction):

 A patient’s guide to adult acquired flatfoot deformity or tibialis posterior tendon dysfunction

Images used by permission of RNOH

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