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Buckling flat foot – Pes planovalgus

Dysfunction of the tibialis posterior tendon

A bent flat foot is caused by a dysfunction of the so-called tibialis posterior tendon, for example triggered by tendinitis of the foot. Accidents can also be a trigger for a bent flat foot. When tendon function fails, the longitudinal arch of the foot drops. This results in foot pain and restricted movement, the individual causes of which can be identified by modern diagnostics and alleviated with optimal treatment.

Find out on our website what the bent flatfoot as a functional disorder of the tibialis posterior tendon means for you and what treatments we can offer you at the Orthopaedic Center Munich East (OZMO) for complaints as well as for prevention. If you or your relatives are affected, we would be pleased to hear from you to make an appointment.

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Orthopädie Zentrum München Ost - Fuß - Erkrankungen

Table of Contents:

What is meant by a bent flat foot?

Symptoms of a bent flat foot
Causes of a bent flat foot

Diagnostics for functional disorders of the tibialis posterior tendon
Treatment for buckling flat foot
Make your appointment at OZMO for bent low foot and foot dysfunction.

What is meant by a bent flat foot?

The bent flat foot, medically known as pes planovalgus, is a deformity of the foot. The healthy foot forms a longitudinal and a transverse arch, through which an elastic and at the same time stable structure enables standing and walking. If the heel bends inwards due to injury or incorrect stress, the result is a bent foot. In addition, if the longitudinal arch of the foot flattens, the sole of the foot becomes flat and rests on the ground. This is called flat foot or, in extreme flattening, flat foot. Both variants usually occur together, which is why it is then referred to as a bent flat foot.

Kinky flat foot can develop in childhood when foot maturation is delayed or impeded (e.g., by improper footwear during development), but also occurs in adulthood. The infantile bent flat foot can grow out on its own or with medically supervised auxiliary therapies, while the deformity should always be treated in adults to avoid complications and secondary diseases of the musculoskeletal system.

Symptoms of a bent flat foot

The symptoms of a flat foot depend on the stage of the deformity and its individual manifestation. Thus, depending on the situation at hand, there may be pain on exertion or permanent pain with or without ankle swelling and limitation of movement. The pain is usually localized around the ankle, but may radiate into the lower leg.

A typical feature of a flat foot is the irregular wear of the shoes worn, which, if not replaced and/or compensated for by orthopedic insoles or orthopedic shoes, increases the symptoms of a flat foot in the long term.

Causes of a bent flat foot

In childhood, a bent flat foot usually grows out if the foot maturation is supported by conducive footwear. If, on the other hand, the bent flat foot is acquired, it is primarily due to damage to the muscles and tendons, which results in wear or insufficient function of the tibialis posterior tendon. Typical pre-existing conditions are found in previous foot injuries, tendinitis of the foot, arthritis, rheumatism or external ligament injuries.

If the tendon loop shifts due to pre-existing conditions or problems in foot development, the arch of the foot can no longer be adequately stabilized. The fibula muscle also acts on the foot, lowering the longitudinal arch of the foot. The movement of the foot when walking and standing is thus impaired, resulting in pain due to the uneven distribution of weight, renewed overloading of parts of the foot and ultimately in restricted movement when rolling the foot.

Diagnostics for functional disorders of the tibialis posterior tendon

Although an experienced orthopedic surgeon can quickly recognize a bent flat foot, only careful diagnosis reveals the cause and extent of the foot malposition. Thus, the diagnosis is divided into several steps, which subsequently allow to derive the individually appropriate treatment. The examinations are structured accordingly in

clinical examination of the foot,
orthopedic tests and
imaging techniques.

The examinations will show whether the patient has only one-sided pain on the foot, whether there is pressure pain over the tendon or whether there is swelling. Orthopedic testing is performed to determine the range of motion and to check for abnormal loading and dysfunction of the tibialis posterior tendon. Stability tests of tendons and muscles are also necessary for a necessary differential diagnosis. As imaging procedures, X-rays or ultrasound examinations round out the diagnosis of a bent flat foot, while a foot pressure measurement (podometry) and a dynamic gait analysis clear up any final doubts for the orthopedist.

Treatment for buckling flat foot

Treatment for a bent flat foot usually begins with conservative measures. Physical therapy exercises can help prevent tibialis posterior tendon rupture, while anti-inflammatory medications relieve present inflammation and promote strengthening of the tendon through exercise. Good footwear is considered essential as an accompaniment, with sturdy shoes with elevating insoles for the inner edge of the foot helping to improve foot structure. Depending on the severity of the deformity, orthopedic inserts and orthopedic shoes may be necessary.

If there is no success for the bent flat foot or if it is already in an advanced stage, surgery by the orthopedic foot specialist may be necessary. Various surgical procedures are then considered on an individual basis to implement the best option for the patient and mitigate the bent flat foot. Depending on the initial situation, a tendon transfer or lengthening of the outer edge of the foot can be performed. The correct treatment is always individual to remedy complaints with a bent foot, a flat foot or the widespread combination disease of bent and flat foot.

Make your appointment at OZMO for bent low foot and foot dysfunction.

If you notice laterally worn soles on your footwear or if there is pain and restricted movement in your feet, the expert examination at the Orthopädie Zentrum München Ost (OZMO) offers you the best possible assistance. Among our three highly qualified and experienced orthopedic specialists, Dr. med. Meinhard Balensiefen, as a hand and foot specialist, takes over most of the patients in order to assist them after a careful diagnosis with advice and action as well as with goal-oriented treatments for a bent flat foot.

Make your appointment today with our accomplished practice team for an examination of flat foot and foot dysfunction at your Orthopedic Center Munich East (OZMO).

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