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Adult-Acquired Flatfoot Deformity

Home » Conditions » Adult-Acquired Flatfoot Deformity

Adult-Acquired Flatfoot Deformity

Acknowledge Foot Pain & Seek Innovative Treatment

Adult-acquired flatfoot deformity (AAFD) is a painful, progressive condition that occurs when the soft tissues of the foot are overstretched and torn, causing the arch of the foot to collapse.

The posterior tibial tendon attaches to the bones on the inside of the foot, maintains the foot’s arch and provides the strength needed for feet to effectively push-off while walking. When this tendon loses its function, the bones will spread out of their aligned position and the foot will become “flat”—causing individuals to develop adult-acquired flatfoot deformity.

Without an AAFD repair, the condition may progress until the affected foot becomes entirely rigid and quite painful.


Who’s At Risk?

Reduce your risk.

Common risk factors associated with adult-acquired flatfoot deformity include:

  • Age. The risk of developing the condition increases with age, with middle-aged women between 40 and 60 being three times more likely to be affected by the condition than men.
  • Weight. Obese individuals consistently carry more weight, meaning that their bodies steadily experience more stress placed on their feet and ankles. Gradually, bearing extra weight will begin to flatten the arch of the foot, until the foot becomes completely “flat” from the bones spreading out of position.
  • Previous injury. Individuals who have experienced previous ankle trauma or surgery are at a higher risk to develop AAFD due to a previous form of joint deformity.
  • Diabetes. Due to disease-related nerve damage, diabetics are more prone to stressing their posterior tibial tendon and acquiring AAFD.
  • Inflammatory Arthritis. Arthritis degrades the cartilage in the ankle and foot joints and the ligaments that support the foot, causing the foot to change shape over time, eventually flattening it to cause adult-acquired flatfoot deformity.


Pinpoint your pain.

Common symptoms of adult-acquired flatfoot deformity include:

  • Pain and/or swelling. As a result of inflammation of the nerve inside the tarsal tunnel, tenderness where the posterior tendon resides may occur and be accompanied by a burning, shooting, tingling or stabbing pain.
  • Difficulty walking. Individuals may experience a constant ache while walking long distances or an inability to walk altogether.
  • Change in foot shape. As an individual’s tendon stretches, the arch in their foot flattens, causing a change in the shape of the foot.
  • Inability to tiptoe. If an individual’s posterior tendon is damaged, he or she may find it difficult, painful or impossible to raise their heels or stand solely on their foot’s toes.


Get the answers you need.

Diagnosis for adult-acquired flatfoot deformity is accomplished through a combination of physical evaluations and imaging tools, such as X-rays and MRIs.



Life’s too short to put up with pain.

If caught early, adult-acquired flatfoot can be effectively managed through non-surgical treatments, such as bracing, custom-molded orthotics or cast immobilization.When conservative care fails, our physicians will select a surgical treatment that will restore mobility, reduce pain and stop the progression of this serious foot condition. A surgical treatment will be selected that best suits your needs. Procedure options include tendon transfer, tendon debridement and joint fusion. Our foot and ankle surgeons may also perform an osteotomy, which involves surgically cutting and reshaping a bone to realign the foot.

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