That nagging ache on the inside of your ankle, the way your arch seems to be dropping a little more each month, the swelling that just won’t quit — these aren’t signs of “getting older.” They’re warning signs of adult-acquired flatfoot, a progressive condition that can rob you of mobility if left untreated. The good news is that early intervention can stop the deformity in its tracks and get you back on your feet comfortably.
At Sweeney Foot & Ankle Specialists, Dr. D. Sean Sweeney, DPM, FACFAS, and Dr. Christy Leahey, DPM, FACFAS, bring more than 20 years of trusted expertise to diagnosing and treating complex tendon conditions. Voted Best Podiatrist in The Woodlands by Living Magazine every year since 2012, our team blends compassionate care with leading-edge technology to help you walk more easily.
What Is Adult-Acquired Flatfoot?
Adult-acquired flatfoot — sometimes called posterior tibial tendon dysfunction or insufficiency — is a painful, progressive collapse of the arch caused by the gradual stretching and weakening of the tibialis posterior tendon and supporting ligaments. As these tissues fail, the bones of the arch shift out of position, the heel tilts inward, and the foot rolls into pronation.
This condition affects women four times more often than men and typically develops in middle to older adulthood, with most patients already having mild flatfoot. Contributing risk factors include diabetes, hypertension, and obesity.
Recognizing the Three Stages
- Stage I: Inflammation and swelling along the inside of the ankle, with the tendon still intact.
- Stage II: A visible, flexible deformity — the arch flattens noticeably compared to the other foot, but correction is still possible.
- Stage III: A rigid, fixed flatfoot with pain shifting to the outside of the ankle as the foot dislocates from beneath the joint.
How Adult Flatfoot Is Diagnosed
No single test definitively identifies this condition, which is why a skilled clinician’s hands-on evaluation is so important. During your visit, we observe how you walk, test muscle strength, and perform the single-foot heel raise — if you cannot lift onto your toes or your heel fails to invert, the posterior tibial tendon may be compromised. X-rays, MRI, or ultrasound may be ordered when additional detail is needed, though imaging alone does not confirm the diagnosis.
Treatment Options
Early treatment offers the best outcome. In Stage I, rest, immobilization in a cast or walking boot, and anti-inflammatory care calm the tendon, followed by custom orthotics and supportive footwear to maintain stability. Our in-office physical therapy and MLS laser therapy — an FDA-cleared treatment with an 85–90% efficacy rate for pain and inflammation — can accelerate recovery and quiet symptoms.
For Stage II, a custom ankle-foot orthosis such as the Richie, Arizona, California, or gauntlet brace provides excellent support and fits into most lace-up shoes. When conservative care no longer controls pain or progression, surgical options — including a minimally invasive Subtalar Arthroereisis implant for flexible deformities — may restore alignment and function.
Why Choose Sweeney Foot & Ankle Specialists for Adult Flatfoot Treatment in The Woodlands, TX?
Our practice has earned a word-of-mouth reputation across Greater Houston for combining warm, patient-centered care with the most advanced tools in podiatry. From custom orthotics and gait analysis to MLS laser therapy, Nano Flex regenerative injections, in-office physical therapy, and surgical correction, we offer a complete continuum of care under one roof. Patients appreciate our prompt appointments, clear explanations, and the personal attention that has made Dr. Sweeney a recognized leader in foot and ankle medicine for more than two decades.
Take the Next Step Toward Pain-Free Movement
Adult-acquired flatfoot will not resolve on its own, but with timely, expert care, you can stop the progression, ease the pain, and protect your mobility for years to come. Schedule your consultation with Sweeney Foot & Ankle Specialists at our Woodlands office at (281) 292-4944 or our Magnolia office at (281) 789-4956, and let our team build a treatment plan that fits your life.