The biomechanics and function of the arch of the foot is crucial to normal walking gait and biomechanics. The support of the mid-foot of the foot is achieved by a number of elements, including the shape of the bones, the ligaments, the muscles and the plantar fascia. One of the essential muscles in the functional stability of the mid-foot of the feet are the posterior tibial muscle. This is a powerful muscle that is in the leg. The tendon of this muscle passes around the medial side of the ankle joint and attaches below the bones that make up the mid-part of the arch of the foot, so this particular muscle is really essential for supporting the arch. In some people, this muscle appears to lose it capability to support the feet, resulting in a condition referred to as Posterior Tibial Tendon Dysfunction.
This problem typically starts off with a moderate discomfort in the arch or medial side of the ankle joint and the mid-foot of the feet progressively flattens and the ankle rolls inwards pronates. This is all as a result of the muscle being unable to do its job adequately. If therapy is not started, then the pain and deformity progresses. In its end stages it is usually quite debilitating and painful. It gradually has a substantial impact on quality of life and the ability to walk. It's very exhausting as a lot of energy is necessary to walk with posterior tibial tendon dysfunction.
As the long term outcomes of this disorder can be so debilitating, it is important that it must be caught as early as possible and treatment begun. The longer the delay the harder it is to deal with. During the early stages, the only adequate intervention usually are very hard or stiff foot orthoses. Weather resistant be firm as the forces that are flattening the feet are so high that they must be resisted. A less firm orthoses will be flattened. A high top hiking or basketball like footwear or sneaker is also helpful at stabilising the rearfoot. If this is not adequate then more complex ankle supports are the next step. If this does not work or the treatment is started too late, then surgery is usually the only good enough intervention at this stage.