The biomechanics and function of the mid-foot ( arch ) of the feet are essential to normal walking and running gait and biomechanics. The support of the arch of the foot is looked after by a number of things, such as the shape of the bones, the ligaments, the muscles and the plantar fascia. One of the key muscles in the dynamic stability of the arch of the feet are the posterior tibial muscle. It is a strong muscle that is in the lower leg. The tendon of this muscle passes on the medial side of the ankle joint and attaches below the bones that make up the mid-part of the arch of the feet, so this particular muscle is really essential for stabilizing the arch. In many individuals, the posterior tibial muscle appears to lose it capability to stabilize the foot, causing a disorder referred to as posterior tibial tendon dysfunction or adult acquired flat foot.
This disorder usually commences with a moderate discomfort in the arch or inside of the ankle joint and the arch of the foot gradually lowers and the rearfoot rolls inwards (pronates). This is all because of the muscle being unable to do its job properly. If therapy is not started, then the pain and deformity progresses. In its end stages it usually is quite debilitating and painful. It gradually has a major affect on quality of life and also the ability to walk. It's very exhausting as so much energy is required to walk with Posterior Tibial Tendon Dysfunction.
Because the long term consequences of this disorder may be so disabling, it is crucial that it must be detected as soon as possible and treatment begun. The lengthier the delay the more difficult it is to treat. During the early stages, the only satisfactory intervention usually are very hard or rigid foot orthotics. They need to be rigid as the forces which are flattening the feet are so high that they need to be countered. A less rigid support will do nothing. A high top hiking or basketball like shoe or sneaker can also be beneficial at supporting the ankle joint. If this is not adequate then more complex ankle braces would be the next stage. If this fails or the treatment is started far too late, then surgery is usually the only satisfactory intervention at this late stage.