Arch Collapse (Tibialis Posterior Tendinopathy/ dysfunction)

Patients commonly present with a unilateral acquired flat foot deformity. Bilateral presentation is rare. Pain typically presents around the medial (inside) aspect of the foot around tibialis posterior insertion and the arch area. In severe cases pain may present laterally (outside) due to impingement related to the severity of the flattened foot. The patient will find doing heel lifts on the affected side painful and difficult. The heel may stay in eversion (turned out) in severe cases indicating advance pathology and tendon rupture.

The condition is classified into 4 stages of severity and the stage of severity is linked to the progression and type of treatment. Greater deformity will require greater support with foot orthoses assisted by appropriate footwear.

As the condition progressed ankle foot orthoses may also be required and surgery in severe cases.

There is a greater incidence in females, a link to obesity, hormonal changes, hypertension, diabetes, trauma and steroid treatment.