Foot & Ankle Center of Arizona - Blog

Adult Flatfoot (PCFD) Treatment in Arizona | Foot & Ankle Center

Written by Dr. Rebecca Varney | Jul 9, 2026 2:07:39 PM

Many patients think flat feet are simply a cosmetic issue. In reality, progressive collapsing foot deformity (PCFD), also known as adult flatfoot deformity, is a condition that can worsen over time and lead to pain, disability, and arthritis if left untreated.

As foot and ankle surgeons, we commonly see patients who initially notice mild arch pain or ankle swelling, only to discover that their foot and even ankle alignment has gradually changed over the years.

What Causes Adult Flatfoot?

The most common cause of adult flatfoot is dysfunction of the posterior tibial tendon, an important structure that helps support the arch and stabilize the foot during walking. As this tendon weakens and supporting ligaments stretch, the arch begins to collapse, the heel drifts outward, and the foot becomes progressively flatter.

Common Symptoms

Patients with PCFD often experience:

  • Pain along the inside of the ankle or arch
  • Swelling near the posterior tibial tendon
  • A flattening of the foot or loss of arch height
  • Difficulty standing on tiptoes and increased bunion deformity
  • Fatigue with prolonged walking or exercise
  • Pain on uneven surfaces

As the condition progresses, pain may also develop along the outside of the foot and ankle due to abnormal joint loading.

It May Be Affecting More Than Your Foot

Because the foot serves as the foundation of the body, a collapsing arch can contribute to symptoms throughout the lower extremity. Patients may also experience:

  • Plantar fasciitis and Achilles tendon tightness
  • Shin splints
  • Knee pain
  • Hip discomfort
  • Low back pain
  • Balance problems and early fatigue

Many patients are surprised to learn that longstanding knee, hip, or back symptoms may be related to abnormal foot mechanics.

Treatment Options for Adult Flatfoot Deformity

Early treatment can often slow progression and relieve symptoms without the need for surgery. Depending on the severity of the deformity, treatment may include:

  • Custom orthotics or supportive bracing
  • Physical therapy
  • Activity modification
  • Anti-inflammatory treatments
  • Regenerative medicine options, such as PRP injection, are available for selected patients

When non-surgical treatment is no longer effective, surgical reconstruction may be recommended. Modern flatfoot reconstruction is highly individualized and may involve tendon repair, ligament reconstruction, realignment osteotomies, Achilles lengthening, or other procedures designed to restore function and preserve long-term foot health.

Why Choose The Foot and Ankle Center of Arizona?

At The Foot and Ankle Center of Arizona, we specialize exclusively in foot and ankle conditions, allowing us to provide expert care for the full spectrum of progressive collapsing foot deformity. Our evaluation goes beyond identifying where the pain is located—we focus on understanding why it developed and how it affects your overall function.

We believe in a patient-centered, individualized approach to care. Every patient's goals, lifestyle, and deformity are unique, and treatment should reflect that. Depending on your needs, treatment may include custom orthotics, bracing, physical therapy, regenerative medicine treatments, or advanced reconstructive surgery.

Our goal is simple: provide personalized treatment that relieves pain, restores function, and helps you stay active and moving confidently for years to come.