You May Have Fallen Arches?
Overview
Feet usually have an arch on the inside portion of the foot. A flat foot is a foot that has lost or never developed this arch. It is often associated with the lower part of the legs being angled outwards. Most flat feet are flexible. This type rarely causes problems and usually do not require treatment. Rigid flat feet can cause problems and are best treated.
Causes
An acute injury, such as from a fall, can tear the posterior tibial tendon or cause it to become inflamed. The tendon can also tear due to overuse. For example, people who do high-impact sports, such as basketball, tennis, or soccer, may have tears of the tendon from repetitive use. Once the tendon becomes inflamed or torn, the arch will slowly fall (collapse) over time. Posterior tibial tendon dysfunction is more common in women and in people older than 40 years of age. Additional risk factors include obesity, diabetes, and hypertension.
Symptoms
Pain and stiffness of the medial arch or anywhere along the mid-portion of the foot. Associated discomfort within and near the ankle joint. The knees, hips, and lower back may be the primary source of discomfort. Feet may often feel tired and achy. Painful shin splints may develop with activity. Gait may be awkward.
Diagnosis
You can test yourself to see if you have flat feet or fallen arches by using a simple home experiment. First, dip your feet in water. Then step on a hard flat surface, like a dry floor or a piece of paper on the floor, where your footprints will show. Step away and examine your foot prints. If you see complete/full imprints of your feet on the floor, you may have fallen arches. However, it?s important to seek a second option from a podiatrist if you suspect you have fallen arches so they can properly diagnose and treat you.
pes planus radiology
Non Surgical Treatment
There are different modalities of treatment that are available to manage flat feet and fallen arches. The type of treatment that is chosen depends upon how severe the condition is and what symptoms the patients are experiencing. Below is a brief description of the available treatment modalities. In the event that the patient is experiencing swelling of the feet, rest and ice application is usually the initial treatment step. Oral anti-inflammatories may be offered which can help reduce inflammation as well as associated pain. Physical therapy has good outcomes and can include different exercises such as stretches and strengthening of the surrounding muscles. Changes in footwear and activity modification are also important when dealing with a painful flat (pronated) foot. These days, orthotic insoles are easily available either over the counter or through your Podiatrist which can effectively help maintain the arch of the foot and reduce the amount of stress placed on the foot. Podiatrists are able to prescribe a variety of different devices from prefabricated to customized and are trained to determine the most appropriate device for each individual. In order to offer the right kind of orthotic insole, podiatrists may perform a test called gait analysis. This involves asking the patient to walk and videoing the different movements that the foot of forms during the walking. Features such as over pronation can be easily seen on this and orthotic insoles can be prescribed to correct the specific abnormalities that are picked up on this analysis. Overall, orthotic treatment can result in a significant improvement in foot movement and reduction in foot discomfort.
Surgical Treatment
Surgery is typically offered as a last resort in people with significant pain that is resistant to other therapies. The treatment of a rigid flatfoot depends on its cause. Congenital vertical talus. Your doctor may suggest a trial of serial casting. The foot is placed in a cast and the cast is changed frequently to reposition the foot gradually. However, this generally has a low success rate. Most people ultimately need surgery to correct the problem. Tarsal coalition. Treatment depends on your age, extent of bone fusion and severity of symptoms. For milder cases, your doctor may recommend nonsurgical treatment with shoe inserts, wrapping of the foot with supportive straps or temporarily immobilizing the foot in a cast. For more severe cases, surgery is necessary to relieve pain and improve the flexibility of the foot. Lateral subtalar dislocation. The goal is to move the dislocated bone back into place as soon as possible. If there is no open wound, the doctor may push the bone back into proper alignment without making an incision. Anesthesia is usually given before this treatment. Once this is accomplished, a short leg cast must be worn for about four weeks to help stabilize the joint permanently. About 15% to 20% of people with lateral subtalar dislocation must be treated with surgery to reposition the dislocated bone.
Prevention
Flatfeet in children are often an inherited family trait, but it may be possible to prevent the condition in some cases. Recent research has shown that there are several social or cultural factors that can cause flatfeet. These factors include the following, obesity, overweight, unnecessary orthopedic treatments, wearing rigid shoes at a young age, In 1992, a study in India of 2300 children aged 4-13 demonstrated a significant difference in the rate of flatfeet among those who wore shoes regularly and those who did not. In this study, wearing inflexible, closed-toe shoes in early childhood was shown to have a negative effect on the normal development of arches. Children who were allowed to go barefoot or who wore light sandals and slippers had a much lower rate of flatfeet. In 1999, a study in Spain of 1181 children aged 4-13 revealed that the use of orthopedic shoes for treatment of flatfeet in children not only failed to correct the problem, but actually worsened the condition by preventing the normal flexing and arch development of bare or lightly protected feet. Finally, in 2006, a study of 835 children aged 3-6 showed significant differences in the rate of flatfeet based on weight, with normal-weight children having lower rates of flatfeet than children who were overweight or obese. Among adults, flatfeet due to injury, disease, or normal aging are not preventable. However, when flatfeet are related to lifestyle factors, such as physical activities, shoe selection, and weight gain, careful attention to these factors may prevent the development of flatfeet.
After Care
Time off work depends on the type of work as well as the surgical procedures performed. . A patient will be required to be non-weight bearing in a cast or splint and use crutches for four to twelve weeks. Usually a patient can return to work in one to two weeks if they are able to work while seated. If a person's job requires standing and walking, return to work may take several weeks. Complete recovery may take six months to a full year. Complications can occur as with all surgeries, but are minimized by strictly following your surgeon's post-operative instructions. The main complications include infection, bone that is slow to heal or does not heal, progression or reoccurrence of deformity, a stiff foot, and the need for further surgery. Many of the above complications can be avoided by only putting weight on the operative foot when allowed by your surgeon.
Feet usually have an arch on the inside portion of the foot. A flat foot is a foot that has lost or never developed this arch. It is often associated with the lower part of the legs being angled outwards. Most flat feet are flexible. This type rarely causes problems and usually do not require treatment. Rigid flat feet can cause problems and are best treated.
Causes
An acute injury, such as from a fall, can tear the posterior tibial tendon or cause it to become inflamed. The tendon can also tear due to overuse. For example, people who do high-impact sports, such as basketball, tennis, or soccer, may have tears of the tendon from repetitive use. Once the tendon becomes inflamed or torn, the arch will slowly fall (collapse) over time. Posterior tibial tendon dysfunction is more common in women and in people older than 40 years of age. Additional risk factors include obesity, diabetes, and hypertension.
Symptoms
Pain and stiffness of the medial arch or anywhere along the mid-portion of the foot. Associated discomfort within and near the ankle joint. The knees, hips, and lower back may be the primary source of discomfort. Feet may often feel tired and achy. Painful shin splints may develop with activity. Gait may be awkward.
Diagnosis
You can test yourself to see if you have flat feet or fallen arches by using a simple home experiment. First, dip your feet in water. Then step on a hard flat surface, like a dry floor or a piece of paper on the floor, where your footprints will show. Step away and examine your foot prints. If you see complete/full imprints of your feet on the floor, you may have fallen arches. However, it?s important to seek a second option from a podiatrist if you suspect you have fallen arches so they can properly diagnose and treat you.
pes planus radiology
Non Surgical Treatment
There are different modalities of treatment that are available to manage flat feet and fallen arches. The type of treatment that is chosen depends upon how severe the condition is and what symptoms the patients are experiencing. Below is a brief description of the available treatment modalities. In the event that the patient is experiencing swelling of the feet, rest and ice application is usually the initial treatment step. Oral anti-inflammatories may be offered which can help reduce inflammation as well as associated pain. Physical therapy has good outcomes and can include different exercises such as stretches and strengthening of the surrounding muscles. Changes in footwear and activity modification are also important when dealing with a painful flat (pronated) foot. These days, orthotic insoles are easily available either over the counter or through your Podiatrist which can effectively help maintain the arch of the foot and reduce the amount of stress placed on the foot. Podiatrists are able to prescribe a variety of different devices from prefabricated to customized and are trained to determine the most appropriate device for each individual. In order to offer the right kind of orthotic insole, podiatrists may perform a test called gait analysis. This involves asking the patient to walk and videoing the different movements that the foot of forms during the walking. Features such as over pronation can be easily seen on this and orthotic insoles can be prescribed to correct the specific abnormalities that are picked up on this analysis. Overall, orthotic treatment can result in a significant improvement in foot movement and reduction in foot discomfort.
Surgical Treatment
Surgery is typically offered as a last resort in people with significant pain that is resistant to other therapies. The treatment of a rigid flatfoot depends on its cause. Congenital vertical talus. Your doctor may suggest a trial of serial casting. The foot is placed in a cast and the cast is changed frequently to reposition the foot gradually. However, this generally has a low success rate. Most people ultimately need surgery to correct the problem. Tarsal coalition. Treatment depends on your age, extent of bone fusion and severity of symptoms. For milder cases, your doctor may recommend nonsurgical treatment with shoe inserts, wrapping of the foot with supportive straps or temporarily immobilizing the foot in a cast. For more severe cases, surgery is necessary to relieve pain and improve the flexibility of the foot. Lateral subtalar dislocation. The goal is to move the dislocated bone back into place as soon as possible. If there is no open wound, the doctor may push the bone back into proper alignment without making an incision. Anesthesia is usually given before this treatment. Once this is accomplished, a short leg cast must be worn for about four weeks to help stabilize the joint permanently. About 15% to 20% of people with lateral subtalar dislocation must be treated with surgery to reposition the dislocated bone.
Prevention
Flatfeet in children are often an inherited family trait, but it may be possible to prevent the condition in some cases. Recent research has shown that there are several social or cultural factors that can cause flatfeet. These factors include the following, obesity, overweight, unnecessary orthopedic treatments, wearing rigid shoes at a young age, In 1992, a study in India of 2300 children aged 4-13 demonstrated a significant difference in the rate of flatfeet among those who wore shoes regularly and those who did not. In this study, wearing inflexible, closed-toe shoes in early childhood was shown to have a negative effect on the normal development of arches. Children who were allowed to go barefoot or who wore light sandals and slippers had a much lower rate of flatfeet. In 1999, a study in Spain of 1181 children aged 4-13 revealed that the use of orthopedic shoes for treatment of flatfeet in children not only failed to correct the problem, but actually worsened the condition by preventing the normal flexing and arch development of bare or lightly protected feet. Finally, in 2006, a study of 835 children aged 3-6 showed significant differences in the rate of flatfeet based on weight, with normal-weight children having lower rates of flatfeet than children who were overweight or obese. Among adults, flatfeet due to injury, disease, or normal aging are not preventable. However, when flatfeet are related to lifestyle factors, such as physical activities, shoe selection, and weight gain, careful attention to these factors may prevent the development of flatfeet.
After Care
Time off work depends on the type of work as well as the surgical procedures performed. . A patient will be required to be non-weight bearing in a cast or splint and use crutches for four to twelve weeks. Usually a patient can return to work in one to two weeks if they are able to work while seated. If a person's job requires standing and walking, return to work may take several weeks. Complete recovery may take six months to a full year. Complications can occur as with all surgeries, but are minimized by strictly following your surgeon's post-operative instructions. The main complications include infection, bone that is slow to heal or does not heal, progression or reoccurrence of deformity, a stiff foot, and the need for further surgery. Many of the above complications can be avoided by only putting weight on the operative foot when allowed by your surgeon.
