Flat feet, also known as fallen arches, affect many adults—especially women—as they age. This condition can develop slowly over time and is often painful, especially after walking or standing for long periods. In this article, we explore flat feet symptoms, the most common causes of flat feet, and how medical devices for flat feet, such as orthotics and braces, can support your recovery.
What is Tibialis Posterior Tendon Dysfunction (Adult Acquired Flat Foot)?
Sometimes known as adult-acquired flat feet, or sometimes ‘fallen arches’, tibialis posterior tendon dysfunction is one of the most widespread foot complaints in adults. It occurs when the arch in the foot progressively flattens over an extended period of time, with an associated loss of function that sometimes results in pain.
What Causes a Flat Foot
The condition can be caused by a variety of factors, including injury to or deterioration of tendons that support the arch of the foot. Abnormalities in the structure or function of joints and bones may also play a role in developing flat feet. The condition can become painful in later adulthood, causing aching and weakness in the foot, ankle and knee.
There are several reasons for flat feet to develop in adulthood, often referred to as adult-acquired flat foot. The most common causes of flat foot include:
- Injury or inflammation of the tibialis posterior tendon
- Structural abnormalities in the foot or ankle
- Joint conditions such as arthritis
- Obesity or weight gain
- Hormonal changes in female flat feet (e.g., pregnancy)
- Diabetes and aging
Understanding the reason for flat foot development is essential to creating the right treatment plan.
Flat Feet Symptoms in Adults
Many people may have low arch profiles but a progressive collapsing in adults may be a sight of AAFF. Flat feet symptoms can present differently in men and women. Some female patients with flat feet experience more noticeable arch collapse during pregnancy or menopause due to hormonal shifts and ligament laxity.
This condition can become painful, causing aching and weakness in the foot, ankle and knee. It may also lead to problems in the hips and lower back due to poor postural alignment caused by weak feet. Symptoms of flat feet include:
- Pain in the foot and inside of the ankle that is more noticeable after standing or walking for long periods
- Difficulty walking (especially longer distances) or trouble climbing stairs. This may be harder on one side than the other
- Loss of ability to stand on tippy toes
- Fatigue in the feet after prolonged standing/walking/playing sports
- Swelling along the inside of the foot and ankle, more specifically, the tarsal tunnel
- Change in the angle of the foot when walking, with a possible increased bulge or bowing on the inside edge
Diagnosis
During your consultation, your podiatrist will examine your feet to observe them from the front and back, possibly while walking or standing on your toes. They may also assess the wear pattern of your shoes for an indication of which areas of your feet make the most contact with the ground when you walk.
Your podiatrist may also order further diagnostic imaging such as an X-ray, MRI, CT scan or ultrasound to identify which structures may be damaged or sensitive and rule out any serious damage or more complicated issues that may be contributing to your pain.
Treatment
The good news about an adult-acquired flat foot is that it can generally be treated successfully with minimal non-invasive treatments including:
In confirmed AAFF we would initially look to increased comfort by supporting the collapsed arch, this may be achieved with taping, footwear modification or arch supports.
Arch supports/orthotic devices
Your podiatrist may suggest inner soles or other orthotic devices for arch support to correct your flat feet. In more advanced cases, devices such as a Ritchie Brace or moon boot may be used on a short-term basis.
Supportive footwear
If you are suffering from flat feet, you may need to change your footwear to something that offers better support for your arches. Ask your treatment provider for their recommendations.
Once there is some improvement your podiatrist may start to incorporate some flexibility and strengthening work to help you get back to your sport or activity
Prevention
Early identification of changes in the shape of your arch or the strength of the foot may be the best way to prevent further complications or progression of the injury. Footwear appropriate to your activity may also lower your risk.
Medical Devices for Flat Feet
If your podiatrist confirms a diagnosis of adult-acquired flat feet, they may recommend one or more medical devices to relieve pain and improve function. These may include:
Orthotic insoles to support the arch and control pronation
Ritchie Braces, designed to stabilise the ankle and support the tibialis posterior tendon
Moon boots or controlled ankle movement (CAM) walkers, used for short-term support after flare-ups or injuries
Taping and compression gear, to reduce swelling and strain
These flat feet medical devices are often used alongside physiotherapy or strength work to restore mobility and confidence.
Summary
Adult-acquired flat foot is a common affliction that can be managed effectively with a number of non-surgical treatments including physical therapy and orthotic devices. Symptoms can include pain, fatigue and difficulty walking.
If you’re experiencing flat feet symptoms such as pain, swelling, or fatigue, our expert podiatrists at Spine Sport Feet Helensvale can help. We offer custom orthotic devices, medical bracing, and long-term rehabilitation to help restore your mobility.
