Foot arch is an anatomical structure that springs and removes the load carried by the foot from the body. This structure consists of bones and soft tissues. The tibialis posterior tendon, which we call soft tissue, ensures that the bone structure remains in a curved shape. Tibialis posterior tendon insufficiency occurs in people who did not have any pressing problems in childhood but developed flat feet as they got older (especially after the age of 60).
Tibialis posterior tendon insufficiency occurs with the decrease in tendon quality and strength with advancing age. . In these patients, the condition develops slowly, and the patient's complaints gradually increase over the years. However, in patients with rheumatoid arthritis and diabetes, this tendon may become dysfunctional due to the damage caused by the disease. In this group of patients, the condition develops acutely (suddenly) and progresses rapidly (weeks-months).
Patients first notice that the inner arch of the foot has disappeared, and then their walking distance decreases. Over time, problems such as foot pain, swelling, various bone deformities, and ankle pain are added to the table.
Shoe modification, special insoles, and protective wristbands can be used in the early stages of the treatment of the disease. Physical therapy and rehabilitation programs can be added to the treatment. In advanced stages, surgeries are recommended to patients with the principle of correcting the foot anatomy with various surgical methods.