The progressing worsening of a flat foot or dropped arch of the foot in an adult is usually named posterior tibial tendon dysfunction as well as adult acquired flatfoot and could have serious implications if not diagnosed early on and addressed. Posterior tibial tendon dysfunction is more common in older in addition to obese adults. The main concern is how the posterior tibial muscles which are the reason for supporting the arch of the feet are not very good at carrying out that, and so a gradual flattening of the foot comes about. As well as a collapsing of the arch of the feet there may be generally increasing pain and discomfort in the arch of the feet and also the ankle joint. As it moves along, further walking becomes increasingly harder and it is quite tireing.

There are commonly four steps involving posterior tibial tendon dysfunction that this condition advances through with 1 being the early stage and four being the final phase that only surgery can deal with. There is a bit of disagreement with the classifications with this as their is variability between health care professionals and some reliability concerns. While acknowledging that, stage one is commonly treated with foot supports along with exercises and some relief for the pain and discomfort. Stage two characteristically requires much more aggressive and supporting foot orthotics, continuing with the exercise routines along with increasing amounts of pain alleviation medicines are usually necessary. Both stages one and two will benefit with high top supporting shoes. Long term weight loss plans may also be likely to be beneficial. If that does not halt the progression and the feet are proceeding towards a stage three, then there is increasing likelihood that reconstructive foot surgical procedures are probably going to be necessary. That is why it's very crucial that there be more intense conservative management of the foot when it is still at stage two to stop the development.

An increasingly common solutions for adult acquired flat foot as it progresses to stage 2 would be Richie Brace. This the Richie Brace is being widely used and has been shown to be very effective at stopping the advancement with this condition and avoiding the requirement for surgical treatment. Surgical interventions are often effective, but there is often a residual measure of impairment left over as the surgical procedures commonly does need the fusing of some important joints and the moving of muscles insertions with other parts of the foot. The Richie brace is a combination of an aggressively supportive bespoke foot orthotic plus an ankle foot orthoses with struts to aid each side of the joints at the ankle. The custom foot orthotic is crafted from a plaster cast or optical scan of the foot with the foot kept in a fixed alignment. The intention of the foot orthoses section of the Richie Brace is to make an effort to hold the foot in that corrected posture. The struts which get added up the side of the ankle joint are articulated at the ankle joint permitting motion to take place at this joint. These struts are then held on by Velcro on the lower leg to help aid and enhance the influence of the foot orthoses. Generally if the progression of posterior tibial tendon dysfunction can be halted making use of this, then surgical treatment is commonly averted.