The biomechanics and functionality of the mid-foot of the feet are critical to normal walking and running gait and biomechanics. The stability of the mid-foot of the foot is maintained by a number of things, for example the shape of the bones, the ligaments, the muscles as well as the plantar fascia. One of many critical muscles in the functional stability of the mid-foot of the feet are the posterior tibial muscle. It is a powerful muscle that is in the leg. The tendon of this muscle passes along the inside of the ankle joint and inserts below the bones that comprise the mid-part of the arch of the foot, so this particular muscle is so important for supporting the arch. In many people, this muscle appears to lose it capability to support the feet, causing a disorder known as Posterior tibial tendon dysfunction or adult acquired flat foot.
This disorder generally commences with a moderate ache in the midfoot or inside of the ankle joint and the longitudinal arch of the feet gradually collapses and the ankle joint rolls inwards. This is all as a result of the muscle not being able to do its job adequately. If treatment is not implemented, then the pain and deformity progresses. In its later stages it usually is very debilitating and painful. It eventually has a significant effect on total well being and the ability to walk. It is extremely tiring as a lot of energy is necessary to walk with posterior tibial tendon dysfunction.
Because the long term outcomes of this disorder may be so debilitating, it is crucial that it is caught as early as possible and treatment started. The lengthier the delay the more difficult it is to treat. In the early phases, the only adequate treatment usually are quite hard or stiff foot orthotics. They must be firm as the forces which are lowering the feet are so high that they must be opposed. A less rigid orthoses will do nothing. A high top hiking or basketball like shoe or boot is also helpful at stabilising the ankle joint. If this isn't satisfactory then more complicated ankle braces could be the next intervention. If this fails or the therapy is started far too late, then surgical intervention is actually the only suitable treatment at this late stage.