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Flatfoot (Midfoot)

There are many causes of flatfoot disorder.  The most common type is adult acquired flatfoot disorder caused by posterior tibialis tendon dysfunction.  This tendon can become diseased, insufficient and finally rupture.  It can happen at any age but occurs most often to women in their 40s.  Dysfunction of this tendon is the inciting event that leads to the cascade of bony and soft tissue changes that result in flatfoot deformity. The posterior tibialis tendon is responsible to maintain the medial longitudinal arch of the foot.  It also provides opposition to the pull of the peroneal brevis tendon on the lateral aspect of the foot and ankle.  With no pull of the tibialis posterior tendon, the medial arch collapses, the hindfoot drifts into a valgus position and the midfoot is rotated laterally by the pull of the peronial brevus tendon.

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