Tibialis Posterior Dysfunction (Acquired Flat Foot)
NHS Tayside RefGuide
Warning
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.
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.