Adult Aquired Flat Feet

Overview

Often considered solely a product of genetics, flatfoot rarely carries with it the stigma of presenting over time. The truth, however, is that flatfoot does not discriminate on the basis of age and can become an issue in the form of adult-acquired flatfoot. Like its congenital cousin, adult-acquired flatfoot deformity is one that, in causing structural damage to the foot (and particularly to the posterior tibial tendon), creates an imbalance that may result in any number of symptoms, including inflammation, pain, stiffness, limited mobility, and even arthritis.Flat Foot


Causes

Many health conditions can create a painful flatfoot, an injury to the ligaments in the foot can cause the joints to fall out of alignment. The ligaments support the bones and prevent them from moving. If the ligaments are torn, the foot will become flat and painful. This more commonly occurs in the middle of the foot (Lisfranc injury), but can also occur in the back of the foot. In addition to ligament injuries, fractures and dislocations of the bones in the midfoot can also lead to a flatfoot deformity.


Symptoms

Symptoms shift around a bit, depending on what stage of PTTD you?re in. For instance, you?re likely to start off with tendonitis, or inflammation of the posterior tibial tendon. This will make the area around the inside of your ankle and possibly into your arch swollen, reddened, warm to the touch, and painful. Inflammation may actually last throughout the stages of PTTD. The ankle will also begin to roll towards the inside of the foot (pronate), your heel may tilt, and you may experience some pain in your leg (e.g. shin splints). As the condition progresses, the toes and foot begin to turn outward, so that when you look at your foot from the back (or have a friend look for you, because-hey-that can be kind of a difficult

maneuver to pull off) more toes than usual will be visible on the outside (i.e. the side with the pinky toe). At this stage, the foot?s still going to be flexible, although it will likely have flattened somewhat due to the lack of support from the posterior tibial tendon. You may also find it difficult to stand on your toes. Finally, you may reach a stage in which your feet are inflexibly flat. At this point, you may experience pain below your ankle on the outside of your foot, and you might even develop arthritis in the ankle.


Diagnosis

Perform a structural assessment of the foot and ankle. Check the ankle for alignment and position. When it comes to patients with severe PTTD, the deltoid has failed, causing an instability of the ankle and possible valgus of the ankle. This is a rare and difficult problem to address. However, if one misses it, it can lead to dire consequences and potential surgical failure. Check the heel alignment and position of the heel both loaded and during varus/valgus stress. Compare range of motion of the heel to the normal contralateral limb. Check alignment of the midtarsal joint for collapse and lateral deviation. Noting the level of lateral deviation in comparison to the contralateral limb is critical for surgical planning. Check midfoot alignment of the naviculocuneiform joints and metatarsocuneiform joints both for sag and hypermobility.


Non surgical Treatment

It is imperative that you seek treatment should you notice any symptoms of a falling arch or PTTD. Due to the progressive nature of this condition, your foot will have a much higher chance of staying strong and healthy with early treatment. When pain first appears, your doctor will evaluate your foot to confirm a flatfoot diagnosis and begin an appropriate treatment plan. This may involve rest, anti-inflammatory medications, shoe modifications, physical therapy, orthotics and a possible boot or brace. When treatment can be applied at the beginning, symptoms can most often be resolved without the need for surgery.

Flat Feet


Surgical Treatment

Flatfoot reconstruction (osteotomy). This is often recommended for flexible flatfoot condition. Flatfoot reconstruction involves cutting and shifting the heel bone into a more neutral position, transferring the tendon used to flex the lesser toes (all but the big toe) to strengthen the posterior tibial tendon, and lengthening the calf muscle. Fusion (also known as triple arthrodesis). Fusion involves fusing, or making stiff, three joints in the back of the foot the subtalar, talonavicular, and calcaneocuboid joints, to realign the foot and give it a more natural shape. Pins or screws hold the area in place until it heals. Fusion is often recommended for a rigid flatfoot deformity or evidence of arthritis. Both of these surgeries can provide excellent pain relief and correction.

My Aching Foot

This exercise can help strengthen and alleviate pain felt in your lower leg as a result of flat feet. Stand with your hands flat against a wall. Place one foot in front with your knee slightly bent and your foot flat on the ground. Your other foot should be slightly backwards, with your heel on the ground and your leg straight. Slowly lean forward. When you feel a stretch in your calf muscle, stop and hold this position for a count of 30 seconds. Repeat one set of 5 repetitions for each leg. You can rest for a few seconds in between repetitions. Towel Stretch

A diagnosis of flat feet can usually be made by a physical exam. In most cases, though the doctor will make the patient undergo several other tests to pinpoint the underlying cause or causes of the flat foot or over pronation. In most cases, a flat foot remains flexible and no treatment is needed if the flat footedness does not cause problems. But if the arch does not manifest even when the patient stands on his or her toes, the doctor will likely ask for an x-ray. If the doctor suspects a tendon injury, and MRI may be required. Flat foot treatment optionsflat feet knee pain

Seek out decreased volume boots. A boot with lower volume has a lot less room for your feet to fill compared to a higher volume level boot. People who have flat feet have feet that do not fill up a whole lot of room within their hiking boots and definitely will need lower volume boots so that their feet are not swimming around in the actual boots. Go to Best Hiking Boots For You to find out about the best hiking boots for your feet We have the most up-to-date hiking boot reviews, and we update you about the newest hiking boot promotions and hiking boot sales.

As you can see, my ankles are straightening up a bit and I have the start of some very pretty arches – even on my left foot which was always the worst one. Are my flat feet “fixed” yet – no, but there is significant improvement. I have a little over 5 months to go before we hike the PCT, so they have more time to get stronger before our big adventure. At least now I feel very confident that I don’t have to have my toenails surgically removed to complete this hike!flat feet surgery

I would not have found my way through this journey so strongly and clearly without having read “Anatomy of the Spirit” by Caroline Myss just months after my initial surgery. It must have been late 1996 when I read it. I remember my sister had it and I picked it up and looked through the pages with the charts on them. It was in this very moment that I finally felt for the first time ever that I had real insight into what I had just gone through with my cancer and what I had been experiencing in my body my entire life.