Adult acquired flatfoot
is a very serious condition that can lead to many secondary deformities, not
only within the foot but also in the knees, hips and back. This presentation discusses a new scientifically proven procedure that may be able to help realign and fix this problem at its
Flat feet causes greater pressure on the posterior tibial tendon than normal. As the person with flat feet ages, the muscles, tendons and ligaments weaken. Blood supplies diminish as arteries narrow.
These conditions are magnified for obese patients because of their increased weight and atherosclerosis. Finally, the tendon gives out or tears. Most of the time, this is a slow process. Once the
posterior tibial tendon and ligaments stretch, body weight causes the bones of the arch to move out of position. The foot rotates inward (pronation), the heel bone is tilted to the inside, and the
arch appears collapsed. In some cases, the deformity progresses until the foot dislocates outward from the ankle joint.
Symptoms are minor and may go unnoticed, Pain dominates, rather than deformity. Minor swelling may be visible along the course of the tendon. Pain and swelling along the course of the tendon. Visible
decrease in arch height. Aduction of the forefoot on rearfoot. Subluxed tali and navicular joints. Deformation at this point is still flexible. Considerable deformity and weakness. Significant pain.
Arthritic changes in the tarsal joints. Deformation at this point is rigid.
In diagnosing flatfoot, the foot & Ankle surgeon examines the foot and observes how it looks when you stand and sit. Weight bearing x-rays are used to determine the severity of the disorder.
Advanced imaging, such as magnetic resonance imaging (MRI) and computed tomography (CAT or CT) scans may be used to assess different ligaments, tendons and joint/cartilage damage. The foot &
Ankle Institute has three extremity MRI?s on site at our Des Plaines, Highland Park, and Lincoln Park locations. These extremity MRI?s only take about 30 minutes for the study and only requires the
patient put their foot into a painless machine avoiding the uncomfortable Claustrophobia that some MRI devices create.
Non surgical Treatment
Because of the progressive nature of PTTD, early treatment is critical. If treated soon enough, symptoms may resolve without the need for surgery and progression of the condition can be stopped. If
left untreated, PTTD may create an extremely flat foot, painful arthritis in the foot and ankle, and will limit your ability to walk, run, and other activities. Your podiatrist may recommend one or
more of these non-surgical treatments to manage your PTTD. Orthotic devices or bracing. To give your arch the support it needs, your foot and ankle surgeon may recommend an ankle brace or a custom
orthotic device that fits into your shoe to support the arch. Immobilization. A short-leg cast or boot may be worn to immobilize the foot and allow the tendon to heal. Physical therapy. Ultrasound
therapy and stretching exercises may help rehabilitate the tendon and muscle following immobilization. Medications. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, help reduce the
pain and inflammation. Shoe modifications. Your foot and ankle surgeon may recommend changes in your footwear.
For more chronic flatfoot pain, surgical intervention may be the best option. Barring other serious medical ailments, surgery is a good alternative for patients with a serious problem. There are two
surgical options depending on a person?s physical condition, age and lifestyle. The first type of surgery involves repair of the PTT by transferring of a nearby tendon to help re-establish an arch
and straighten out the foot. After this surgery, patients wear a non-weight bearing support boot for four to six weeks. The other surgery involves fusing of two or three bones in the hind foot below
the ankle. While providing significant pain relief, this option does take away some hind foot side-to-side motion. Following surgery, patients are in a cast for three months. Surgery is an effective
treatment to address adult-acquired flatfoot, but it can sometimes be avoided if foot issues are resolved early. That is why it is so important to seek help right away if you are feeling ankle pain.
But perhaps the best way to keep from becoming flatfooted is to avoid the risk factors altogether. This means keeping your blood pressure, weight and diabetes in check.