Painful progressive flatfoot

Painful progressive flatfoot is a deformity in adults that occurs when soft tissues (tendons and ligaments) have been gradually stretched or torn and cannot support the arch of the foot.

Individuals with flat feet are more likely to develop painful progressive flatfoot because of the greater load placed on the posterior tibial tendon, which is the main tendon supporting the arch of the foot. Aging leads to decreased strength of muscles, tendons and ligaments causing the posterior tibial tendon to stretch, tear or give out. This process is typically gradual and includes inflammation and degeneration of the tendon. Once the tendon is stretched, ligaments of the arch stretch and tear. The weight of the body can further press down causing the bones of the arch of the foot to move out of position.


Painful progressive flatfoot affects women more than men. It occurs primarily in individuals who already have flat feet. Contributing factors include diabetes, hypertension and obesity.


Inflammation, pain and swelling of the posterior tibial tendon around the inside of the ankle are symptoms of painful progressive flatfoot. The foot may appear flatter and deformed. As the condition progresses, the foot becomes rigid and non-moving.

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