I always enjoy reading about the hereditary disposition for a foot complaint but always struggle to know what to Rx to address the deficiency. Oh well.... it makes for a good stocking filler when talking to a patient about matrix metalloproteases, polymorphisms and alleles....
I don't have access but will hazard a guess the 'dysfunction' is a consequence of the tendinopathy. The authors evaluate identifiable gene polymorphism and variations between control v disease group. In any event, it's of little consequence to the management protocol. Somewhat like hallux valgus and familial / genetic tendency. Makes for an educated discussion with a patient but it's a 'so what'. Too late to change your parents.
I have noticed that there is a particular patient who always comes in with posterior tib dysfunction. The narrow foot, with pes planus as a child that gets progressively worse with age. Too bad they don't come in as a child and wait until their ankle and knees begin to hurt. Unfortunately, foot care is an afterthought for so many people. A good orthotic as a child can make such a difference for so many patients.
Teri: I concur the narrow unstable foot is often the 'pes planus' foot (talot tarsal subluxation foot). In my patient population this foot-type does not commonly dominate the correlation with PTTD . Instead the fat, forty & female characterization, often holds true. Along with the finding of the medially deviated STJ axis. Be that,as it may, I also want to believe
this is a preventable problem if only proactive, early, intervention, can be implemented. Alas, we'll never know. I have come to realize, over the last 30 years, that assigning the female 'psyche' away from summer sandals and 'pretty shoes' towards 'sensible shoes and foot orthoses' for the promise of a 'better foot' is (mostly) beyond my powers. If only there was an internal orthotic ;-)
Association of estrogen receptor β polymorphisms with posterior tibial tendon dysfunction
P. R. B. Nogara, A. L. Godoy-Santos, F. C. P. Fonseca, C. Cesar-Netto, K. C. Carvalho, E. C. Baracat, N Maffulli, P. A. Pontin & M. C. L. Santos Molecular and Cellular Biochemistry (2020)