Flat Foot (Adult Acquired Flat Foot) – Symptoms, Causes & Treatments
Flat Foot Treatment at a Glance
- What it is: progressive collapse of the foot arch, usually driven by posterior tibial tendon dysfunction (PTTD).
- Key symptoms: inner foot or ankle pain, swelling, overpronation and a visibly flattened arch.
- Non-surgical treatment first: custom orthotics, shockwave and laser therapy, plus rehabilitation exercises.
- Act early: the sooner PTTD is diagnosed, the more of the arch can be preserved.
- Next step: gait analysis and diagnostic ultrasound at our Sydenham, Covent Garden and Croydon clinics.
Source: NHS – Flat feet
Trusted Podiatrists and Chiropodists in London
Flat foot, also known as adult acquired flat foot, is often caused by posterior tibial tendon dysfunction (PTTD). This condition involves the progressive flattening of the foot arch and the inward rolling (pronation) of the ankle, typically due to the weakening or overuse of the posterior tibial tendon—a key structure responsible for supporting the arch of the foot.
At Flawless Feet Podiatry & Laser Clinic in London, we specialise in diagnosing and treating flat foot conditions, including biomechanical alignment issues and structural foot imbalances, using evidence-based, non-invasive treatments that help prevent long-term foot deformities and restore mobility.
What is Posterior Tibial Tendon Dysfunction (PTTD)?
PTTD refers to the malfunction or degeneration of the posterior tibial tendon, often due to overuse, biomechanical issues, injury, or general wear and tear. As the tendon weakens, it loses its ability to support the foot's arch, causing it to collapse gradually.
Once thought to affect mainly the elderly, this condition is now more common among younger individuals who are overweight, wear unsupportive footwear, or participate in high-impact activities.
What Causes Flat Foot and PTTD?
Several factors can contribute to the development of flat foot and PTTD, including:
- Genetic predisposition – Flat feet can run in the family, and an inherited foot structure may make the arch more prone to collapsing.
- Poor foot mechanics – Overpronation places excess strain on the posterior tibial tendon with every step.
- Improper footwear – Unsupportive shoes fail to cushion and support the arch, accelerating tendon fatigue.
- Injury or trauma – Ankle or foot injuries can damage the posterior tibial tendon and disrupt arch support.
- Medical conditions – Obesity, diabetes, hypertension and inflammatory arthritis all increase the risk of tendon degeneration.
- Repetitive strain – High-impact activities such as running, tennis or basketball place repeated load on the tendon.
Flat foot rarely develops overnight—the arch gradually collapses as the posterior tibial tendon weakens, making early intervention crucial.
Risk Factors for Flat Foot and PTTD
- Pre-existing flat foot
- Foot or ankle injuries
- Multiple pregnancies
- Hypermobility (loose ligaments)
- Age over 40
- Obesity
- Diabetes or hypertension
- Participation in high-impact sports
- Poor footwear (e.g., slippers or unsupportive shoes)
Common Symptoms of Flat Foot
Flat foot symptoms can progress over time and may include:
- Pain and tenderness on the inside of the foot and ankle
- Swelling in the ankle or foot (may or may not be visible)
- Pain that worsens during physical activities like walking or running
- Progressive flattening of the foot arch
- Pain in the ankle due to joint compression
- Tingling or numbness due to nerve irritation along the inside of the foot
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How is Flat Foot Diagnosed?
At Flawless Feet Podiatry & Laser Clinic, your podiatrist will:
- Assess your walking (gait analysis)
- Examine your foot posture and joint range of motion
- Test muscle strength and foot function
- Use diagnostic ultrasound or imaging if needed to evaluate tendon health and identify the stage of flat foot deformity
Treatment Options for Flat Foot in London
1. Foot Orthotics
Orthotics help redistribute pressure and support the arch, preventing the condition from worsening. Custom-made orthotics are designed to fit your foot and shoe type, whether for daily use, sports, or formal wear.
2. Therapies (Laser & Shockwave)
We use advanced modalities such as Low-Level Laser Therapy and Shockwave Therapy to stimulate tendon healing, reduce inflammation, and relieve pain without surgery.
3. Rehabilitation Exercises
Targeted stretching and strengthening programmes are often prescribed to support tendon recovery, improve foot biomechanics, and prevent future collapse.
4. Footwear Guidance
We provide tailored advice on appropriate footwear that supports your arch and reduces tendon strain—especially important for active individuals or those with physically demanding jobs.
5. Compression for Symptom Relief
While home remedies such as compression with an elastic wrap or bandage can help reduce swelling, they are not a long-term solution. Compression alone is unlikely to resolve the underlying condition. It should be used as a temporary relief measure only, before seeking proper podiatric management.
Why Choose Flawless Feet Podiatry & Laser Clinic?
If you're experiencing symptoms of flat foot or posterior tibial tendon dysfunction, don't wait for it to worsen. Early diagnosis and treatment can help prevent long-term issues.
- Highly experienced podiatrists and chiropodists in London with expertise in managing flat foot conditions
- Access to state-of-the-art treatments including shockwave and laser therapy
- Customised orthotic solutions made in-house
- Multiple clinics across London – Sydenham, Covent Garden, and Croydon
- Friendly, professional, and holistic approach to recovery
Frequently Asked Questions
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