The deltoid ligament is a large, strong ligament that connects the ankle to the heel bone and the bones of the inside of the foot. In addition to the spring ligament, there are other smaller ligaments connecting the small bones of the inside of the foot that also help support the arch. If this ligament is not injured before the PCFD, it is often torn, or at least stretched, in later stages of flatfoot. Sometimes, there is an injury to the spring ligament before PTT function starts to worsen.

It is most commonly believed that dysfunction of the PTT is one of the main issues that contributes to the development of a flatfoot. Whether inflammation and dysfunction (poor function) of these structures are the cause or effect (result) of flatfoot is difficult to say. The posterior tibial tendon attaches the calf muscle to the bones on the inside of the foot. However, surgery is usually very involved (complex), and most patients will still notice some limitation in activity after surgery.Surgery might be as simple as removing the inflamed tissue or repairing a simple tear in the tendon.Surgical options vary widely depending on the stage of the disease and degree (amount) of deformity. If orthotics and braces do not provide relief, surgery can be an effective way to help with the pain and improve the function of the foot. Most patients in the early stages of the disease can be treated without surgery, using orthotics and braces. DescriptionĪs the name would suggest, progressive collapsing foot deformity represents a broad range of disorders that may start as a subtle (not obvious) deformity with only mild symptoms but can progress to a very painful, debilitating (crippling), and dysfunctional (poorly functioning) flatfoot. When the tendon becomes inflamed or torn, it may not be able to provide stability and support for the arch of the foot, resulting in flatfoot. Though likely the result of a constellation (connected group) of problems, flatfoot is most commonly believed to begin with dysfunction of the posterior tibial tendon, an important structure in supporting the arch of the foot. Another name for this condition is posterior tibial tendon dysfunction (PTTD). Progressive collapsing foot deformity (PCFD), formerly known as adult acquired flatfoot (AAF), is a complex condition of the foot and ankle that results in flattening of the arch of the foot as well as other more subtle (less obvious) deformities.

Arch pain in foot and back of knee