Sudden onset flatfoot (posterior tibial tendon dysfunction)

Warning

Please see list of red flags

Assessment

Signs & symptoms

  • Audible snap or pop during activity*
  • Sudden and significant pain in calf or medial ankle*
  • Unable to single leg heel raise*
  • Swelling and bruising*
  • Collapse of medial longitudinal arch.

Risk factors

  • Trauma*
  • Antibiotic use (fluroroquinolones, doxycycline, tetracycline, macrolides)*

* Relevant for most tendon ruptures

When & how to refer

Urgent fracture/soft tissue clinic or A&E referral.

Editorial Information

Next review date: 01/10/2027

Author(s): Reid J.

Version: 01.0

Approved By: Trauma & Orthopaedics Acute Governance