Peter Attia· MD
the most common sort of acquired problem is poster tibialis tendon deficiency where there's attenuation and stretch of the posterior tibialis tendon and that's the tendon that supports the arch and over time that just starts getting stretched out as you can imagine it's a mechanical issue and unless it can keep itself in prime shape it's going to stretch out over time just due to the forces that it's under and when it does the foot starts changing shape the foot starts changing how it loads and pain is the most frequent presenting problem with a poster tibialis tendon deficiency