Flexible flatfoot is one of the most common types of flatfoot.  It typically begins in childhood or adolescence and continues into adulthood.  It usually occurs in both feet and progresses in severity throughout the adult years.  As the deformity worsens, the soft tissues (tendons and ligaments) of the arch may stretch or tear and can become inflamed.


The posterior tibial tendon serves as one of the major supporting structures of the foot, helping it to function while walking.  Posterior tibial tendon dysfunction (PTTD) is a condition caused by changes in the tendon, impairing its ability to support the arch.  This results in flattening of the foot.

PTTD is often called adult acquired flatfoot because it is the most common type of flatfoot developed during adulthood.  Although this condition typically occurs in only one foot, some people may develop it in both feet.  PTTD is usually progressive, which means it will keep getting worse, especially if it isn’t treated early.

In some patients whose pain is not adequately relieved by other treatments, surgery may be considered.  A variety of surgical techniques are available to correct flexible flatfoot and one or a combination of procedures may be required to relieve the symptoms and improve foot function.

In selecting the procedure or combination of procedures for your particular case, the foot and ankle surgeon will take into consideration the extent of your deformity based on the x-ray findings, your age, your activity level and other factors.  The length of the recovery period will vary depending on the procedure or procedures performed.