All The Things You Want To Know Concerning Arch Pain
Overview
Flat feet and fallen arches are terms used to describe lowering of the long inner arch of the foot. In the past, we thought that flat feet were a sign of a poorly developed or poorly structured foot. Now we know that people with flat feet function generally well and that flat feet don?t cause many foot problems. The most important factor in foot soreness and injury is not how flat or high your arches are, but the way you walk and move. If your feet move abnormally while you are walking or standing, this can make you more prone to injuries and foot soreness.
Causes
Having low or no arches is normal for some people. In these cases, flat feet are usually inherited and the feet are fairly flexible. Occasionally, flat feet can be caused by an abnormality that develops in the womb, such as a problem with a joint or where two or more bones are fused together. This is known as tarsal coalition and results in the feet being flat and stiff. Flat feet that develop in later life can be caused by a condition that affects the joints, such as arthritis, or an injury to a muscle, tendon or joint in the foot.
Symptoms
The groups of muscles that support the arch can be divided into two groups. The muscles on the top of the arch start on the front lower leg and help to lift the arch, and the muscles that help pull the arch on the bottom of the foot are located the on back of the lower leg. Muscle injury may be indicated when pain is felt when the foot is fully extended, flexed, or turned in or out. Pain may also be felt when working the foot against resistance. Bruises are the result of a direct-force injury to the body. A bruise can occur to the foot by a variety of causes, such as having your foot stepped on or by stepping on a rock. The tissues that compose the arch do not provide that area of the body much protection. Blows to the foot that result in pain, discoloration, swelling, and changes in how you walk may indicate more serious damage.
Diagnosis
In people with flat feet, the instep of the foot comes in contact with the ground when standing. To diagnose the problem, the health care provider will ask you to stand on your toes. If an arch forms,the flat foot is called flexible. You will not need any more tests or treatment. If the arch does not form with toe-standing (called rigid flat feet), or if there is pain, other tests may be needed, including a CT scan to look at the bones in the foot. MRI scan to look at the tendons in the foot. X-ray of the foot.
Non Surgical Treatment
Depending on your overall health, symptoms and severity of the the flat foot, the condition may be treated conservatively and/or with surgery. Non-surgical treatments for flat feet are centered at decreasing and/or resolving the symptoms (pain). Simple Treatments Patients Can do themselves include wear proper supportive shoes. Use an arch support. Wear shoes with a wide toe box. Modify your activities. Lose weight. Wear shoes with cushion. Non-surgical treatments a doctor might do include Prescribe an oral anti-inflammatory medication. Anti-inflammatory medication is useful to significantly reduce pain and inflammation. Prescribe physical therapy. A physical therapist may perform ultrasound and other techniques to reduce inflammation. You will also be instructed how to stretch your foot and leg properly. Keeping the joint mobile may preserve function. Strengthening weak foot and leg musculature can help prevent further collapse. Prescribe protective pads. Padding and/or cushioning of when areas of bone become prominent on the bottom of the foot, as an effective method of preventing mechanical irritation with shoes. Pads with cutouts may off-weight specific areas of concern. Prescribe custom foot orthotics. A custom foot orthotic is a doctor prescribed arch support that is made directly from a casting (mold) of your feet, and theoretically should provide superior support compared to shoe insert that you would purchase from a pharmacy. In the case of flat feet, specific modifications can be made to the orthotic device to strategically balance the foot. Prescribe custom ankle-foot orthoses. A custom ankle-foot orthotic (AFO) is a doctor prescribed molded arch and lower leg support that stabilizes both the foot and ankle. This is used when the flat foot is significant and provides more support than the simple foot only insert. Give cortisone injection. A articular cortisone injection is a powerful anti-inflammatory medication that is used to rapidly reduce the pain associated with inflammation. Cortisone shots can be extremely effective in alleviating symptoms of flat feet, but will not correct the structure.
Surgical Treatment
In rare cases, surgery may be needed if a child has flat feet caused by a problem they're born with (a congenital abnormality). The foot may need to be straightened or the bones may need to be separated if they're fused together. Painkillers and insoles are the first treatment options for flat feet that are caused by a joint problem, such as arthritis or a torn tendon. However, surgery may be recommended if the injury or condition is severely affecting your feet. Where flat feet are caused by a condition that affects the nervous system, special shoes, insoles, or supportive foot or leg braces may be needed. Again, in severe cases, an operation may be needed to straighten the feet.
Prevention
There are several things that you can do to prevent and treat arch pain. This includes Avoiding high heeled shoes, Stretching the calf muscles regularly, Wearing well fitted, comfortable shoes, Using customisedorthotic devices or shoe inserts, Elevating the feet and applying ice and taking over-the-counter anti-inflammatory medications. You can also care for your feet by paying attention to any changes in your feet as you get older. It is normal for feet to lose some of their fat pads as a person ages. Your feet may get bigger, both wider and longer as well. Make sure that you wear shoes that are sturdy, but comfortable, and have your feet measured before you buy shoes to make sure that you are still wearing the right size. Shoe sizes vary from one brand to the next, so it is a good idea to have your feet measured every time you purchase shoes. When choosing shoes, match the shoe to the activity for which it will be worn. Within the broader grouping of athletic shoes, there are different categories with different features. For example, a running shoe has different features than a walking shoe. You may develop some arthritic changes in your feet over time, too. If you notice that you are experiencing more pain in your feet, see your doctor for an evaluation. If the pain is arthritis-related, your doctor may recommend medication or other treatment to slow the progression of the arthritis.
Stretching Exercises
Strength training and stretching can help avoid injury and keep your feet free from pain. Stretching should focus on the bottom of your foot to loosen tissues and tight ligaments surrounding your arch. The easiest way to do this is by grabbing a towel and sitting on the floor. You can do this while you catch up on the news in the morning, or when you get home from work. Put one leg out in front with your foot flexed up. Loop the towel around the ball of your foot and gently pull your toes towards you. Hold for thirty seconds and then repeat 3-4 times before switching feet.
Flat feet and fallen arches are terms used to describe lowering of the long inner arch of the foot. In the past, we thought that flat feet were a sign of a poorly developed or poorly structured foot. Now we know that people with flat feet function generally well and that flat feet don?t cause many foot problems. The most important factor in foot soreness and injury is not how flat or high your arches are, but the way you walk and move. If your feet move abnormally while you are walking or standing, this can make you more prone to injuries and foot soreness.
Causes
Having low or no arches is normal for some people. In these cases, flat feet are usually inherited and the feet are fairly flexible. Occasionally, flat feet can be caused by an abnormality that develops in the womb, such as a problem with a joint or where two or more bones are fused together. This is known as tarsal coalition and results in the feet being flat and stiff. Flat feet that develop in later life can be caused by a condition that affects the joints, such as arthritis, or an injury to a muscle, tendon or joint in the foot.
Symptoms
The groups of muscles that support the arch can be divided into two groups. The muscles on the top of the arch start on the front lower leg and help to lift the arch, and the muscles that help pull the arch on the bottom of the foot are located the on back of the lower leg. Muscle injury may be indicated when pain is felt when the foot is fully extended, flexed, or turned in or out. Pain may also be felt when working the foot against resistance. Bruises are the result of a direct-force injury to the body. A bruise can occur to the foot by a variety of causes, such as having your foot stepped on or by stepping on a rock. The tissues that compose the arch do not provide that area of the body much protection. Blows to the foot that result in pain, discoloration, swelling, and changes in how you walk may indicate more serious damage.
Diagnosis
In people with flat feet, the instep of the foot comes in contact with the ground when standing. To diagnose the problem, the health care provider will ask you to stand on your toes. If an arch forms,the flat foot is called flexible. You will not need any more tests or treatment. If the arch does not form with toe-standing (called rigid flat feet), or if there is pain, other tests may be needed, including a CT scan to look at the bones in the foot. MRI scan to look at the tendons in the foot. X-ray of the foot.
Non Surgical Treatment
Depending on your overall health, symptoms and severity of the the flat foot, the condition may be treated conservatively and/or with surgery. Non-surgical treatments for flat feet are centered at decreasing and/or resolving the symptoms (pain). Simple Treatments Patients Can do themselves include wear proper supportive shoes. Use an arch support. Wear shoes with a wide toe box. Modify your activities. Lose weight. Wear shoes with cushion. Non-surgical treatments a doctor might do include Prescribe an oral anti-inflammatory medication. Anti-inflammatory medication is useful to significantly reduce pain and inflammation. Prescribe physical therapy. A physical therapist may perform ultrasound and other techniques to reduce inflammation. You will also be instructed how to stretch your foot and leg properly. Keeping the joint mobile may preserve function. Strengthening weak foot and leg musculature can help prevent further collapse. Prescribe protective pads. Padding and/or cushioning of when areas of bone become prominent on the bottom of the foot, as an effective method of preventing mechanical irritation with shoes. Pads with cutouts may off-weight specific areas of concern. Prescribe custom foot orthotics. A custom foot orthotic is a doctor prescribed arch support that is made directly from a casting (mold) of your feet, and theoretically should provide superior support compared to shoe insert that you would purchase from a pharmacy. In the case of flat feet, specific modifications can be made to the orthotic device to strategically balance the foot. Prescribe custom ankle-foot orthoses. A custom ankle-foot orthotic (AFO) is a doctor prescribed molded arch and lower leg support that stabilizes both the foot and ankle. This is used when the flat foot is significant and provides more support than the simple foot only insert. Give cortisone injection. A articular cortisone injection is a powerful anti-inflammatory medication that is used to rapidly reduce the pain associated with inflammation. Cortisone shots can be extremely effective in alleviating symptoms of flat feet, but will not correct the structure.
Surgical Treatment
In rare cases, surgery may be needed if a child has flat feet caused by a problem they're born with (a congenital abnormality). The foot may need to be straightened or the bones may need to be separated if they're fused together. Painkillers and insoles are the first treatment options for flat feet that are caused by a joint problem, such as arthritis or a torn tendon. However, surgery may be recommended if the injury or condition is severely affecting your feet. Where flat feet are caused by a condition that affects the nervous system, special shoes, insoles, or supportive foot or leg braces may be needed. Again, in severe cases, an operation may be needed to straighten the feet.
Prevention
There are several things that you can do to prevent and treat arch pain. This includes Avoiding high heeled shoes, Stretching the calf muscles regularly, Wearing well fitted, comfortable shoes, Using customisedorthotic devices or shoe inserts, Elevating the feet and applying ice and taking over-the-counter anti-inflammatory medications. You can also care for your feet by paying attention to any changes in your feet as you get older. It is normal for feet to lose some of their fat pads as a person ages. Your feet may get bigger, both wider and longer as well. Make sure that you wear shoes that are sturdy, but comfortable, and have your feet measured before you buy shoes to make sure that you are still wearing the right size. Shoe sizes vary from one brand to the next, so it is a good idea to have your feet measured every time you purchase shoes. When choosing shoes, match the shoe to the activity for which it will be worn. Within the broader grouping of athletic shoes, there are different categories with different features. For example, a running shoe has different features than a walking shoe. You may develop some arthritic changes in your feet over time, too. If you notice that you are experiencing more pain in your feet, see your doctor for an evaluation. If the pain is arthritis-related, your doctor may recommend medication or other treatment to slow the progression of the arthritis.
Stretching Exercises
Strength training and stretching can help avoid injury and keep your feet free from pain. Stretching should focus on the bottom of your foot to loosen tissues and tight ligaments surrounding your arch. The easiest way to do this is by grabbing a towel and sitting on the floor. You can do this while you catch up on the news in the morning, or when you get home from work. Put one leg out in front with your foot flexed up. Loop the towel around the ball of your foot and gently pull your toes towards you. Hold for thirty seconds and then repeat 3-4 times before switching feet.
What Might Cause Achilles Tendon Pain ?
Overview
Achilles Tendonitis is an inflammation of the Achilles Tendon. This tendon attaches the muscles in the calf of the leg to the back of our heels. The Achilles Tendon is a long and thick tendon, which moves our foot down, so that the toes point to the ground (plantar flexion). This tendon can become inflamed due to the following causes. Over utilizing it, such as too much running, especially up or down hill. Trauma, such as a kick to the tendon. Shoe or boot pressure, especially at its attachment to the heel, or just above it. There are over 250,000 injuries to the Achilles Tendon annually. In fact, more Than 10% of all running injuries are to the Achilles tendon. Tendonitis may be classified as either acute or chronic. Acute Achilles Tendonitis comes on quickly, usually after a specific activity or event. It is characterized by an overstretching or tearing of some of the small fibers of the tendon, and causes pain or tenderness when walking or running. It can occur at the insertion (near the attachment to the heel bone, or further up the leg, about 4 or 5 inches above the heel. Acute tendonitis can also follow a specific injury, such as a kick to the tendon while playing soccer. Chronic Achilles Tendonitis develops gradually over time. Many times, you can feel an obvious thickening of the tendon that may be tender when squeezed, due to long standing scarring of the tendon. Pain is also present when walking or during other forms of activity, and feels better at rest.
Causes
Achilles tendinitis is caused by repeated stress to the tendon, not a direct injury. Often times, this can happen from doing too much too soon and not giving your body enough time to rest or adjust to the increase in intensity or amount of exercise. Another contributing factor can be tight calf muscles. Having tight calf muscles and starting an activity can put added stress on the achilles tendon.
Symptoms
There are several types of Achilles tendinitis symptoms, but all of them are closely related. People who suffer from Achilles tendon pain typically have swelling in the Achilles tendon, and that pain can be chronic as the microscopic tears in the area become more prevalent over time. The most intense pain is typically located just a few centimeters above the area where the tendon meets the heel. This area is called the watershed zone, and the amount of blood moving through it is what gives it the highest potential for injury, especially for athletes. Most of the Achilles tendinitis symptoms in people with the condition will happen immediately after they have been inactive for a fairly significant amount of time. That means that the most pain will generally be felt after sitting or lying down for an extended period, or right after waking up in the morning and getting moving. If you aren?t positive that you are suffering specifically from Achilles tendinitis symptoms, consult a doctor to make sure.
Diagnosis
There is enlargement and warmth of the tendon 1 to 4 inches above its heel insertion. Pain and sometimes a scratching feeling may be created by gently squeezing the tendon between the thumb and forefinger during ankle motion. There may be weakness in push-off strength with walking. Magnetic resonance imaging (MRI) can define the extent of degeneration, the degree to which the tendon sheath is involved and the presence of other problems in this area, but the diagnosis is mostly clinical.
Nonsurgical Treatment
See your doctor or sports physiotherapist for further advice. You may be prescribed anti-inflammatory medicine and a rehabilitation programme. Sometimes, the ankle may be put into a walking boot or cast to immobilise the ankle in the short term. Gentle calf stretching is the first stage of rehabilitation. Don?t stretch to the point of pain. Strengthening the Achilles tendon is the second stage. Your doctor or sports physiotherapist will be able to advise you on exercises for this. Special exercises called eccentric calf raises, that contract the calf muscle as it is lengthening (during the lowering part of the movement), are the standard exercise used in the rehabilitation of Achilles tendon injuries. Sometimes a heel raise or orthotics may be useful. As symptoms resolve, resume normal weight-bearing activities gradually. Avoid running until all tenderness has gone. Swimming or cycling in low gear are good replacement activities.
Surgical Treatment
Your doctor may recommend surgery if, after around six months, other treatments haven?t worked and your symptoms are having an impact on your day-to-day life. Surgery involves removing damaged areas of your tendon and repairing them.
Prevention
By properly training the body, an athlete can build the strength of their tendons and muscles. Following a workout and dieting plan, the body will be able to build muscle and strengthen most effectively. Additionally, doing the following can prevent tendinitis. Wearing appropriate shoes will give your foot the support it needs for proper movements of the foot and ankle. Improper movements will put additional stress on your body. Stretching before an athletic activity, Stretching primes the body for a taxing activity. Additionally, this will get your blood flowing and reduce the risk of pulling a muscle. Ask your doctor about orthotics, Custom orthotics can help get your foot into proper alignment. If the foot does not execute proper mechanics, the body will adjust which will cause pain and increase the chances of injury.
Achilles Tendonitis is an inflammation of the Achilles Tendon. This tendon attaches the muscles in the calf of the leg to the back of our heels. The Achilles Tendon is a long and thick tendon, which moves our foot down, so that the toes point to the ground (plantar flexion). This tendon can become inflamed due to the following causes. Over utilizing it, such as too much running, especially up or down hill. Trauma, such as a kick to the tendon. Shoe or boot pressure, especially at its attachment to the heel, or just above it. There are over 250,000 injuries to the Achilles Tendon annually. In fact, more Than 10% of all running injuries are to the Achilles tendon. Tendonitis may be classified as either acute or chronic. Acute Achilles Tendonitis comes on quickly, usually after a specific activity or event. It is characterized by an overstretching or tearing of some of the small fibers of the tendon, and causes pain or tenderness when walking or running. It can occur at the insertion (near the attachment to the heel bone, or further up the leg, about 4 or 5 inches above the heel. Acute tendonitis can also follow a specific injury, such as a kick to the tendon while playing soccer. Chronic Achilles Tendonitis develops gradually over time. Many times, you can feel an obvious thickening of the tendon that may be tender when squeezed, due to long standing scarring of the tendon. Pain is also present when walking or during other forms of activity, and feels better at rest.
Causes
Achilles tendinitis is caused by repeated stress to the tendon, not a direct injury. Often times, this can happen from doing too much too soon and not giving your body enough time to rest or adjust to the increase in intensity or amount of exercise. Another contributing factor can be tight calf muscles. Having tight calf muscles and starting an activity can put added stress on the achilles tendon.
Symptoms
There are several types of Achilles tendinitis symptoms, but all of them are closely related. People who suffer from Achilles tendon pain typically have swelling in the Achilles tendon, and that pain can be chronic as the microscopic tears in the area become more prevalent over time. The most intense pain is typically located just a few centimeters above the area where the tendon meets the heel. This area is called the watershed zone, and the amount of blood moving through it is what gives it the highest potential for injury, especially for athletes. Most of the Achilles tendinitis symptoms in people with the condition will happen immediately after they have been inactive for a fairly significant amount of time. That means that the most pain will generally be felt after sitting or lying down for an extended period, or right after waking up in the morning and getting moving. If you aren?t positive that you are suffering specifically from Achilles tendinitis symptoms, consult a doctor to make sure.
Diagnosis
There is enlargement and warmth of the tendon 1 to 4 inches above its heel insertion. Pain and sometimes a scratching feeling may be created by gently squeezing the tendon between the thumb and forefinger during ankle motion. There may be weakness in push-off strength with walking. Magnetic resonance imaging (MRI) can define the extent of degeneration, the degree to which the tendon sheath is involved and the presence of other problems in this area, but the diagnosis is mostly clinical.
Nonsurgical Treatment
See your doctor or sports physiotherapist for further advice. You may be prescribed anti-inflammatory medicine and a rehabilitation programme. Sometimes, the ankle may be put into a walking boot or cast to immobilise the ankle in the short term. Gentle calf stretching is the first stage of rehabilitation. Don?t stretch to the point of pain. Strengthening the Achilles tendon is the second stage. Your doctor or sports physiotherapist will be able to advise you on exercises for this. Special exercises called eccentric calf raises, that contract the calf muscle as it is lengthening (during the lowering part of the movement), are the standard exercise used in the rehabilitation of Achilles tendon injuries. Sometimes a heel raise or orthotics may be useful. As symptoms resolve, resume normal weight-bearing activities gradually. Avoid running until all tenderness has gone. Swimming or cycling in low gear are good replacement activities.
Surgical Treatment
Your doctor may recommend surgery if, after around six months, other treatments haven?t worked and your symptoms are having an impact on your day-to-day life. Surgery involves removing damaged areas of your tendon and repairing them.
Prevention
By properly training the body, an athlete can build the strength of their tendons and muscles. Following a workout and dieting plan, the body will be able to build muscle and strengthen most effectively. Additionally, doing the following can prevent tendinitis. Wearing appropriate shoes will give your foot the support it needs for proper movements of the foot and ankle. Improper movements will put additional stress on your body. Stretching before an athletic activity, Stretching primes the body for a taxing activity. Additionally, this will get your blood flowing and reduce the risk of pulling a muscle. Ask your doctor about orthotics, Custom orthotics can help get your foot into proper alignment. If the foot does not execute proper mechanics, the body will adjust which will cause pain and increase the chances of injury.
Fallen Arches What You Should Expect
Overview
The loss of the arch of the foot (also known in some cases as the ?instep?) is called a flatfoot. People may have a very low arch or absolutely no arch whatsoever. Whilst most people with flat feet have been that way since a young age, in some people the arch height reduces over time. This can be due to systemic health concerns, degeneration of muscles and joints, hormonal changes or specific injury.
Causes
Fallen arches in adults are caused by several things. Below are some of the most common causes. Abnormalities present from birth. Torn or stretched tendons (resulting from foot injuries or foot strains). Inflammation or damage of the PTT (posterior tibial tendon). The PTT is responsible for connecting the middle of the arch to the ankle and lower leg. Dislocated or broken bones (also as a result of injury). Health problems like rheumatoid arthritis. Nerve problems. Other factors like diabetes, obesity, aging and pregnancy (these factors are known to increase the risk of fallen arches).
Symptoms
The primary symptom of flatfeet is the absence of an arch upon standing. Additional signs of flatfeet include the following. Foot pain. Pain or weakness in the lower legs. Pain or swelling on the inside of the ankle. Uneven shoe wear. While most cases of flatfeet do not cause problems, complications can sometimes occur. Complications include the following, bunions and calluses, inability to walk or run normally, inflammation and pain in the bottom of the foot (plantar fasciitis), tendonitis in the Achilles heel and other ligaments, pain in the ankles, knees, and hips due to improper alignment, shin splints, stress fractures in the lower legs.
Diagnosis
Determining whether you have fallen arches may be as easy as looking at the shape of the middle bottom of your foot. Is there any kind of arch there? If you cannot find any kind of arch, you may have a flat foot. There are, however, other ways to decide in case you're still not sure. Another way to figure out if you have flat feet is to look at a few pairs of your shoes. Where do you see the most wear on the heels? If you notice significant wear in the heel and the ball of the foot extending to the big toe, this means you are overpronating. Overpronators roll their feet too far inward and commonly have fallen arches. To figure out if you have flat feet, you can also do an easy test. Get the bottoms of your feet wet and then step on to a piece of paper carefully. Step off the paper and take a look at the print your foot made. If your print looks like the entire bottom of a foot, your feet are flat. People with an arch will be missing part of the foot on their print since the arch is elevated off of the paper. Regular visits to your podiatrist are highly recommended.
Non Surgical Treatment
Flexible flat feet that are painless do not require treatment. If you have pain due to flexible flat feet, an orthotic (arch-supporting insert in the shoe) can bring relief. With the increased interest in running, many shoe stores carry shoes for normal feet and pronated feet. The shoes designed for pronated feet make long distance running easier and less tiring because they correct for the abnormality. Rigid or painful flat feet require evaluation by a podiatrist. The treatment depends on the cause of the flat feet. For tarsal coalition, treatment starts with rest and possibly a cast. If this fails to improve the pain, surgery may be necessary. For problems with the posterior tibial tendon, treatment may start with rest, anti-inflammatory medications, and shoe inserts or ankle braces. In more advanced cases, surgery may be needed to clean or repair the tendon, or fuse some of the joints of the foot into a corrected position. Flat feet in older adults can be treated with pain relievers, orthotics, and sometimes surgery.
Surgical Treatment
Surgery for flat feet is separated into three kinds: soft tissue procedures, bone cuts, and bone fusions. Depending on the severity of the flat foot, a person?s age, and whether or not the foot is stiff determines just how the foot can be fixed. In most cases a combination of procedures are performed. With flexible flat feet, surgery is geared at maintaining the motion of the foot and recreating the arch. Commonly this may involve tendon repairs along the inside of the foot to reinforce the main tendon that lifts the arch. When the bone collapse is significant, bone procedures are included to physically rebuild the arch, and realign the heel. The presence of bunions with flat feet is often contributing to the collapse and in most situations requires correction. With rigid flat feet, surgery is focused on restoring the shape of the foot through procedures that eliminate motion. In this case, motion does not exist pre-operatively, so realigning the foot is of utmost importance. The exception, are rigid flat feet due to tarsal coalition (fused segment of bone) in the back of the foot where freeing the blockage can restore function.
Prevention
It?s time to take a long hard look at what?s in your closet. Now is the time to toss out shoes that are well worn. You also need to say good-bye to thin-soled shoes that offer zero arch support. If you?re overweight, fallen arches may be a sign the universe is trying to tell you something. You need to lose weight, and odds are, fallen arches are but one of many physical discomforts you are experiencing.
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.
The loss of the arch of the foot (also known in some cases as the ?instep?) is called a flatfoot. People may have a very low arch or absolutely no arch whatsoever. Whilst most people with flat feet have been that way since a young age, in some people the arch height reduces over time. This can be due to systemic health concerns, degeneration of muscles and joints, hormonal changes or specific injury.
Causes
Fallen arches in adults are caused by several things. Below are some of the most common causes. Abnormalities present from birth. Torn or stretched tendons (resulting from foot injuries or foot strains). Inflammation or damage of the PTT (posterior tibial tendon). The PTT is responsible for connecting the middle of the arch to the ankle and lower leg. Dislocated or broken bones (also as a result of injury). Health problems like rheumatoid arthritis. Nerve problems. Other factors like diabetes, obesity, aging and pregnancy (these factors are known to increase the risk of fallen arches).
Symptoms
The primary symptom of flatfeet is the absence of an arch upon standing. Additional signs of flatfeet include the following. Foot pain. Pain or weakness in the lower legs. Pain or swelling on the inside of the ankle. Uneven shoe wear. While most cases of flatfeet do not cause problems, complications can sometimes occur. Complications include the following, bunions and calluses, inability to walk or run normally, inflammation and pain in the bottom of the foot (plantar fasciitis), tendonitis in the Achilles heel and other ligaments, pain in the ankles, knees, and hips due to improper alignment, shin splints, stress fractures in the lower legs.
Diagnosis
Determining whether you have fallen arches may be as easy as looking at the shape of the middle bottom of your foot. Is there any kind of arch there? If you cannot find any kind of arch, you may have a flat foot. There are, however, other ways to decide in case you're still not sure. Another way to figure out if you have flat feet is to look at a few pairs of your shoes. Where do you see the most wear on the heels? If you notice significant wear in the heel and the ball of the foot extending to the big toe, this means you are overpronating. Overpronators roll their feet too far inward and commonly have fallen arches. To figure out if you have flat feet, you can also do an easy test. Get the bottoms of your feet wet and then step on to a piece of paper carefully. Step off the paper and take a look at the print your foot made. If your print looks like the entire bottom of a foot, your feet are flat. People with an arch will be missing part of the foot on their print since the arch is elevated off of the paper. Regular visits to your podiatrist are highly recommended.
Non Surgical Treatment
Flexible flat feet that are painless do not require treatment. If you have pain due to flexible flat feet, an orthotic (arch-supporting insert in the shoe) can bring relief. With the increased interest in running, many shoe stores carry shoes for normal feet and pronated feet. The shoes designed for pronated feet make long distance running easier and less tiring because they correct for the abnormality. Rigid or painful flat feet require evaluation by a podiatrist. The treatment depends on the cause of the flat feet. For tarsal coalition, treatment starts with rest and possibly a cast. If this fails to improve the pain, surgery may be necessary. For problems with the posterior tibial tendon, treatment may start with rest, anti-inflammatory medications, and shoe inserts or ankle braces. In more advanced cases, surgery may be needed to clean or repair the tendon, or fuse some of the joints of the foot into a corrected position. Flat feet in older adults can be treated with pain relievers, orthotics, and sometimes surgery.
Surgical Treatment
Surgery for flat feet is separated into three kinds: soft tissue procedures, bone cuts, and bone fusions. Depending on the severity of the flat foot, a person?s age, and whether or not the foot is stiff determines just how the foot can be fixed. In most cases a combination of procedures are performed. With flexible flat feet, surgery is geared at maintaining the motion of the foot and recreating the arch. Commonly this may involve tendon repairs along the inside of the foot to reinforce the main tendon that lifts the arch. When the bone collapse is significant, bone procedures are included to physically rebuild the arch, and realign the heel. The presence of bunions with flat feet is often contributing to the collapse and in most situations requires correction. With rigid flat feet, surgery is focused on restoring the shape of the foot through procedures that eliminate motion. In this case, motion does not exist pre-operatively, so realigning the foot is of utmost importance. The exception, are rigid flat feet due to tarsal coalition (fused segment of bone) in the back of the foot where freeing the blockage can restore function.
Prevention
It?s time to take a long hard look at what?s in your closet. Now is the time to toss out shoes that are well worn. You also need to say good-bye to thin-soled shoes that offer zero arch support. If you?re overweight, fallen arches may be a sign the universe is trying to tell you something. You need to lose weight, and odds are, fallen arches are but one of many physical discomforts you are experiencing.
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.
