Pronation is a term used to describe the inward leaning motion of the foot and ankle bones towards the arch. The amount of pronation correlates with arch height. The more a person pronates, the flatter the arch will be. Many people who over-pronate do not experience any pain or discomfort. When flat feet become symptomatic, a thorough foot evaluation is recommended.
Posterior Tibial Tendonitis or Adult Acquired Flatfoot is another term used to describe the Painful progressive flatfoot. This occurs when the posterior tibial tendon gets inflamed or injured. The posterior tibial tendon helps to hold the arch in proper position and when this tendon in damaged, a painful lowering or collapse of the arch develops. Chronic rigid flat foot and functional limb length discrepancies can occur if left untreated. Severely rigid flat feet can also lead to posterior tibial tendonitis due to the constant strain of the tendon.
Treatment for symptomatic flatfeet includes topical and oral Nonsteroidal anti-inflammatories, taping and strapping, ice and massage therapy, passive and active physical therapy, and proper fitting arch supports. Always discuss oral medication with your primary care physician prior to taking. When conservative therapy does not alleviate the symptoms of painful flatfeet, surgery may be necessary. Surgery may be required to repair damaged soft tissue structures such as tendons and ligaments. In Severe flatfoot cases, midfoot joint implants and/or bone repair may be required.