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Saturday, October 31, 2009

Posterior tibial tendon dysfunction 

This is the primary cause of acquired flat foot in adults. Essentially the underlying pathomechanics is that the posterior tibial tendon and muscle just give up - they can no longer do their job. Why do they give up? My understanding and experience is that all that all those with posterior tibial tendon dysfunction have a medially located subtalar joint axis. If this is the case, then it means that the posterior tibial tendon will have a much shorter lever arm to the joint axis. This would mean that in these people the muscle would have to work substantially harder than if the tendon had a longer lever arm if the subtalar joint axis was closer to a more normal or average position. After a life time of having to work so much harder, no wonder the tendon and muscle complex just give up. This is becoming more common in runners who start forefoot striking.

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