The biomechanics and function of the mid-foot of the foot is essential to normal walking gait and biomechanics. The stability of the arch of the feet are achieved by a number of elements, including the alignment of the bones, the ligaments, the muscles as well as the plantar fascia. One of several important muscles in the functional support of the arch of the foot is the posterior tibial muscle. It is a strong muscle that is in the leg. The tendon of this muscle passes along the inside of the ankle joint and attaches underneath the bones that comprise the mid-part of the arch of the feet, so this particular muscle is really necessary for stabilizing the arch. In some people, the posterior tibial muscle seems to lose it capability to support the feet, causing a condition known as posterior tibial tendon dysfunction or adult acquired flat foot.
This disorder usually commences with a moderate discomfort in the midfoot or medial side of the ankle joint and the mid-foot ( arch ) of the foot progressively collapses and the ankle joint rolls inwards (pronates). This is all as a result of the muscle being unable to do its job properly. If treatment is not started, then the pain and disability progresses. In its later stages it could be quite disabling and painful. It gradually has a substantial impact on quality of life and also the ability to walk. It is quite exhausting as a lot of energy is needed to walk with Posterior Tibial Tendon Dysfunction.
Since the long term outcomes of this disorder can be so disabling, it is important that it's detected as quickly as possible and treatment started. The lengthier the delay the more difficult it is to treat. During the early stages, the only adequate treatment usually are very hard or rigid foot orthoses. They need to be firm as the forces which are lowering the arch are so high that they must be opposed. A less rigid orthoses will do nothing. A high top trekking or basketball like footwear or sneaker is also beneficial at stabilising the ankle joint. If this is not adequate then more complicated ankle supports are often the next stage. If this does not work or the treatment is started too late, then surgery is often the only good enough treatment at this late stage.