When sitting, an over-pronating foot appears quite normal, i.e. showing a normal arch with room under the underside of the foot. The moment you get up and put weight on your feet the situation changes: the arches lower and the ankle slightly turns inwards. When you walk or run more weight is placed on the feet compared to standing and over-pronation will become more evident. When walking barefoot on tiles or timber floors over-pronation is more visible, compared to walking on carpet or grass.
Most commonly fallen arches in adulthood can arise due to Posterior Tibial Tendon Dysfunction (PTTD). The posterior tibial tendon plays a pivotal role in holding up the arch of the foot, damage to this tendon results in the arch collapsing. Another cause of acquired flat feet in adulthood may be due to Rheumatoid arthritis as this disease attacks the bone, cartilage and ligaments in the foot causing it to change shape and flatten. Injury to the ligament, fracture and/or dislocation of the bones in the mid foot can all lead to a flat foot deformity. Adult acquired flat fleet can also arise in people who have diabetes or a neurological condition which limits normal feeling in the foot, the muscles in feet switch off, the tendons and ligaments weaken, and the arch eventually collapses.
Some people have fallen arches, and they aren?t even aware of it, fallen arches are sometimes asymptomatic and do not always cause pain. However, for others, the following symptoms may be present. Foot pain, particularly in the arches or heels, leg or back pain, feet feel tired quickly, swelling in the feet and difficulty moving the feet.
Your doctor will ask about your symptoms and medical history. A physical and foot exam will be done. Flat feet can be diagnosed by appearance. To determine if the foot is rigid, you may be asked to do some simple tasks.
arch support plantar fasciitis
Non Surgical Treatment
The typical treatment for pain from fallen arches is an arch insert. While many people experience dramatic pain relief from this, others continue to suffer from chronic achy feet despite the arch support. The problem with this approach is that it does not do anything to strengthen the weak ligaments that may be at the root of the problem and, thus, does not alleviate the chronic pain that people with this condition experience. Another standard practice of modern medicine is to use steroids or to prescribe anti-inflammatory medications. However, in the long run, these treatments do more damage than good. Cortisone shots and anti-inflammatory drugs have been shown to produce short-term pain benefit, but both result in long-term loss of function and even more chronic pain by actually inhibiting the healing process of soft tissues and accelerating cartilage degeneration. Plus, long-term use of these drugs can lead to other sources of chronic pain, allergies and leaky gut syndrome.
Since there are many different causes of flatfoot, the types of flatfoot reconstruction surgery are best categorized by the conditions. Posterior tibial tendon dysfunction. In this condition, the tendon connecting the calf muscle to the inner foot is torn or inflamed. Once the tendon is damaged it no longer can serve its main function of supporting the arch of the foot. Flatfoot is the main result of this type of condition and can be treated by the following flatfoot reconstruction surgeries. Lengthening of the Achilles tendon. Otherwise known as gastrocnemius recession, this procedure is used to lengthen the calf muscles in the leg. This surgery treats flatfoot and prevents it from returning in the future. This procedure is often combined with other surgeries to correct posterior tibial tendon dysfunction. Cleaning the tendon. Also known as tenosynovectomy, this procedure is used in the earlier and less severe stages of posterior tibial tendon dysfunction. It is performed before the arch collapses and while the tendon is only mildly affected. The inflamed tissue is cleaned away and removed from the remaining healthy tendon. Tendon transfer. This procedure is done to correct flatfoot and reform the lost arch in the foot. During the procedure, the diseased tendon is removed and replaced by tendon from another area of the foot. If the tendon is only partially damaged, the inflamed part is cleaned and removed then attached to a new tendon. Cutting and shifting bones. Also called an osteotomy, this procedure consists of cutting and reconstructing bones in the foot to reconstruct the arch. The heel bone and the midfoot are most likely reshaped to achieve this desired result. A bone graft may be used to fuse the bones or to lengthen the outside of the foot. Temporary instrumentation such as screws and plates can also be used to hold the bones together while they heal.
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.