Tibialis Posterior Dysfunction (Acquired Flat Foot)

General information 

  • Adult acquired flat foot deformity, gradual onset.
  • Can cause mobility problems in older people.

Symptoms and signs

  • Medial foot and ankle pain, swelling around the medial hind foot.
  • Lack of rear foot inversion on heel raise, flat longitudinal arch
  • Pain that is worse with activity. High-intensity or high-impact activities, such as running, can be very difficult. Some patients can have trouble walking or standing for a long time.
  • Pain lateral ankle as foot collapses.

Primary care management

  • In the acute stage ice and mobilisation as able. 
  • Most patients can be treated without surgery, using orthotics - can be bought from any chemist/ Allardyce/ online.
  • Analgesia or NSAIDS if appropriate

Primary care diagnostics

X-ray - Foot AP standing, lateral and oblique views. 

Useful resources

Who to refer

No improvement after 3 months conservative management.

How to refer

SCI Gateway/Orthopaedics/Foot & Ankle.
Referral will be vetted by AHP and directed to most appropriate healthcare professional. 

Information to include when referring:
  • Duration and any cause of symptoms
  • Indicate site/spread of pain and if pain constant or intermittent, and/or waking at night
  • Indicate ROM/functional loss
  • BMI
  • Include treatment to date
  • XR Result