The Treatment And Cause For Adult Aquired Flat Feet

Overview

A more serious condition, according to ACFAS, is adult-acquired flatfoot, often cause by posterior tibial tendon dysfunction (PTTD). In this case, the tendon that supports the arch weakens and fails, leading to a rigid flatfoot where the arch stays flat even when you aren’t standing. It can lead to a loss of range of motion in the foot and ankle and pain in the arch. The ACFAS clinical guideline recommends that flatfoot caused by PTTD can be treated with custom shoe orthotics, soft casts, walking boots, physical therapy and non-steroidal anti-inflammatory medications. If there is no relief or the condition worsens, then the patient may be referred to surgery.Adult Acquired Flat Feet


Causes

Rheumatoid arthritis This type of arthritis attacks the cartilage in the foot, leading to pain and flat feet. It is caused by auto-immune disease, where the body?s immune system attacks its own tissues. Diabetes. Having diabetes can cause nerve damage and affect the feeling in your feet and cause arch collapse. Bones can also fracture but some patients may not feel any pain due to the nerve damage. Obesity and/or hypertension (high blood pressure) This increases your risk of tendon damage and resulting flat foot.


Symptoms

Often, this condition is only present in one foot, but it can affect both. Adult acquired flatfoot symptoms vary, but can swelling of the foot’s inner side and aching heel and arch pain. Some patients experience no pain, but others may experience severe pain. Symptoms may increase during long periods of standing, resulting in fatigue. Symptoms may change over time as the condition worsens. The pain may move to the foot’s outer side, and some patients may develop arthritis in the ankle and foot.


Diagnosis

The diagnosis of tibialis posterior dysfunction is essentially clinical. However, plain radiographs of the foot and ankle are useful for assessing the degree of deformity and to confirm the presence or absence of degenerative changes in the subtalar and ankle articulations. The radiographs are also useful to exclude other causes of an acquired flatfoot deformity. The most useful radiographs are bilateral anteroposterior and lateral radiographs of the foot and a mortise (true anteroposterior) view of the ankle. All radiographs should be done with the patient standing. In most cases we see no role for magnetic resonance imaging or ultrasonography, as the diagnosis can be made clinically.


Non surgical Treatment

Orthotic or anklebrace, Over-the-counter or custom shoe inserts to position the foot and relieve pain are the most common non-surgical treatment option. Custom orthotics are often suggested if the shape change of the foot is more severe. An ankle brace (either over-the-counter or custom made) is another option that will help to ease tendon tension and pain. Boot immobilization. A walking boot supports the tendon and allows it to heal. Activity modifications. Depending on what we find, we may recommend limiting high-impact activities, such as running, jumping or court sports, or switching out high-impact activities for low-impact options for a period of time. Ice and anti-inflammatory medications. These may be given as needed to decrease your symptoms.

Acquired Flat Foot


Surgical Treatment

Good to excellent results for more than 80% of patients have been reported at five years’ follow up for the surgical interventions recommended below. However, the postoperative recovery is a lengthy process, and most surgical procedures require patients to wear a plaster cast for two to three months. Although many patients report that their function is well improved by six months, in our experience a year is required to recover truly and gain full functional improvement after the surgery. Clearly, some patients are not candidates for such major reconstructive surgery.

Regarding Achilles Tendonitis

Overview

Achilles TendonitisThe Achilles tendon is the largest tendon in the body. Tendons are long, tough cords of tissue that connect muscle to bone. The Achilles tendon is located in the back of the foot and connects your heel bone to your calf muscle. It helps you to walk, run and jump. The Achilles tendon is able to endure stress, but sometimes injury can occur to the tendon when overly stressed. Overuse of the Achilles tendon may cause the tendon to swell, become irritated, inflamed and cause pain. This is Achilles tendinitis. It is a common sports injury related to running, but can happen to anyone who puts a lot of stress on their feet (e.g.: basketball players and dancers). If you do not get treatment for Achilles tendinitis, the problem can become chronic and make it difficult for you to walk.

Causes

Achilles tendonitis is a common sports injury caused by repeated or intense strain on the tendon. But non-athletes also can get it if they put a lot of stress on their feet. Other things that contribute to Achilles tendonitis include. An increase in activity. Starting a training program after a period of inactivity or adding miles or hills to a jogging regimen are two examples of things that put people at risk for Achilles tendonitis. Sports that require sudden starts and stops; for example, tennis and basketball. A change in footwear, or wearing old or badly fitting shoes. New shoes, worn-out shoes, or the wrong size shoes can cause a person’s feet to overcompensate and put stress on the Achilles tendon. Additionally, wearing high heels all the time can cause the tendon and calf muscles to get shorter, and the switch to flat shoes and exercise can put extra strain on the heel. Running up hills. Going uphill forces the Achilles tendon to stretch beyond its normal range. Weak calf muscles, flat arches, “overpronation” (feet that roll in when running), or “oversupination” (feet that roll out when running). Overpronation and oversupination make the lower leg rotate and put a twisting stress on the tendon. Exercising without warming up. Tight calf muscles or muscles that lack flexibility decrease a person’s range of motion and put an extra strain on the tendon. Running or exercising on a hard or uneven surface or doing lunges or plyometrics without adequate training. A traumatic injury to the Achilles tendon.

Symptoms

People with Achilles tendinitis may experience pain during and after exercising. Running and jumping activities become painful and difficult. Symptoms include stiffness and pain in the back of the ankle when pushing off the ball of the foot. For patients with chronic tendinitis (longer than six weeks), x-rays may reveal calcification (hardening of the tissue) in the tendon. Chronic tendinitis can result in a breakdown of the tendon, or tendinosis, which weakens the tendon and may cause a rupture.

Diagnosis

Studies such as x-rays and MRIs are not usually needed to make the diagnosis of tendonitis. While they are not needed for diagnosis of tendonitis, x-rays may be performed to ensure there is no other problem, such as a fracture, that could be causing the symptoms of pain and swelling. X-rays may show evidence of swelling around the tendon. MRIs are also good tests identify swelling, and will show evidence of tendonitis. However, these tests are not usually needed to confirm the diagnosis; MRIs are usually only performed if there is a suspicion of another problem that could be causing the symptoms. Once the diagnosis of tendonitis is confirmed, the next step is to proceed with appropriate treatment. Treatment depends on the specific type of tendonitis. Once the specific diagnosis is confirmed, the appropriate treatment of tendonitis can be initiated.

Nonsurgical Treatment

Your podiatrist may recommend one or more of these treatments to manage your pain. A bandage specifically designed to restrict motion of the tendon. Over the counter, non-steroidal anti-inflammatory medication (ibuprofen). Custom orthotic shoe inserts to relieve stress on the tendon. Rest. Switching to a low impact exercise such as swimming, that does not stress the tendon. Stretching, massage, ultrasound and appropriate exercises to strengthen the muscles that support the achilles tendon. In extreme cases, surgery is necessary to remove the damaged tissue and repair any tears.

Achilles Tendon

Surgical Treatment

Not every Achilles tendon injury or condition requires surgery. It is generally understood by doctors and surgeons, that surgery will introduce more scar tissue into the Achilles tendon. This added scar tissue will be problematic, requiring physical therapy and conservative treatment options post-surgery. If not dealt with properly, your ankle and Achilles tendon could end up in worse condition than before the surgery! This is why surgery is only performed as a last resort.

Prevention

Appropriately warm up and stretch before practice or competition. Allow time for adequate rest and recovery between practices and competition. Maintain appropriate conditioning, Ankle and leg flexibility, Muscle strength and endurance, Cardiovascular fitness. Use proper technique. To help prevent recurrence, taping, protective strapping, or an adhesive bandage may be recommended for several weeks after healing is complete.