Flatfoot in Adults

About a quarter of all Americans have flat feet either by heredity or simply due to aging feet. While flat feet rarely cause any distinct symptoms, damage to the posterior tibial tendon in the lower part of the leg can not only cause flat feet, but also causes pain in the lower part of the leg, above the arch of the foot.

A quick anatomy lesson on the foot

If you developed flat feet as an adult, it’s most likely a result of damage to the posterior tibial tendon. This tendon helps hold up the arch of your foot, and attaches to the calf muscle in the lower part of your leg, runs down towards the ankle and then curves in to attach to the navicular bone located in the middle of the inner aspect of your foot. When you walk, the tendon pulls up on the navicular bone, which helps form the arch of the foot.


When tendon damage leads to flatfoot and pain

A damaged tibial tendon stretches and sags, causing the navicular bone to lose its position. So what might damage the tendon? Overuse or repetitive stress, trauma, or just wear over time can all damage the tendon. Diabetes and high blood pressure also increase one’s risk of damage. Due to the nature of the damage, most symptoms naturally happen more in middle-aged or older adults.

Inflammation in the posterior tibial tendon causes pain from your foot up your lower leg along the tendon. It’s possible to experience some pain behind the ankle bone or higher up on your leg, as well as potential swelling along the tendon. Be aware that you could be changing how you walk and move because of the pain, which adds strain to other parts of your leg, hip and knee. This could cause further pain.


Why you should see the doctor.

Upon examination, your doctor will recommend a treatment plan. If the damage is mild to moderate, treatment could include rest, ice, compression, elevation and non-steroidal anti-inflammatory medications to reduce swelling and inflammation and allow the tendon to repair itself. You may be given a temporary walking cast gives the area time to heal without inflicting more damage. Orthotics and physical therapy can also help strengthen the damaged tendon. If the damage is severe, however, surgery may be the solution.