The Cause For Adult Aquired FlatFoot

Overview

Some people have always had flat feet from a young age. Unfortunately as people reach their fifties they will suddenly have one foot with a flatter arch than the other foot. This situation is termed adult acquired flatfoot. Adult acquired flatfoot is a painful condition occurring in one foot. The common patient profile is a female over the age of 50 with pre-existing flatfeet, high blood pressure, high cholesterol, diabetes and obesity. All of these underlying problems will lead to a weakening of the support structures of the arch. If you have adult acquired flat foot you will not be able to lift your heel off the ground while standing on one leg. Adult acquired flatfoot may develop due to trauma or degeneration of major tendons ankle & foot. Weakness or paralysis of leg muscles can also create a flatfoot deformity.Adult Acquired Flat Feet


Causes

As discussed above, many health conditions can create a painful flatfoot. Damage to the posterior tibial tendon is the most common cause of AAFD. The posterior tibial tendon is one of the most important tendons of the leg. It starts at a muscle in the calf, travels down the inside of the lower leg and attaches to the bones on the inside of the foot. The main function of this tendon is to hold up the arch and support your foot when you walk. If the tendon becomes inflamed or torn, the arch will slowly collapse. Women and people over 40 are more likely to develop problems with the posterior tibial tendon. Other risk factors include obesity, diabetes, and hypertension. Having flat feet since childhood increases the risk of developing a tear in the posterior tibial tendon. In addition, people who are involved in high impact sports, such as basketball, tennis, or soccer, may have tears of the tendon from repetitive use. Inflammatory arthritis, such as rheumatoid arthritis, can cause a painful flatfoot. This type of arthritis attacks not only the cartilage in the joints, but also the ligaments that support the foot. Inflammatory arthritis not only causes pain, but also causes the foot to change shape and become flat. The arthritis can affect the back of the foot or the middle of foot, both of which can result in a fallen arch.


Symptoms

Posterior tibial tendon insufficiency is divided into stages by most foot and ankle specialists. In stage I, there is pain along the posterior tibial tendon without deformity or collapse of the arch. The patient has the somewhat flat or normal-appearing foot they have always had. In stage II, deformity from the condition has started to occur, resulting in some collapse of the arch, which may or may not be noticeable. The patient may feel it as a weakness in the arch. Many patients initially present in stage II, as the ligament failure can occur at the same time as the tendon failure and therefore deformity can already be occurring as the tendon is becoming symptomatic. In stage III, the deformity has progressed to the extent where the foot becomes fixed (rigid) in its deformed position. Finally, in stage IV, deformity occurs at the ankle in addition to the deformity in the foot.


Diagnosis

Diagnostic testing is often used to diagnose the condition and help determine the stage of the disease. The most common test done in the office setting are weightbearing X-rays of the foot and ankle. These assess joint alignment and osteoarthritis. If tendon tearing or rupture is suspected, the gold standard test would be MRI. The MRI is used to check the tendon, surrounding ligament structures and the midfoot and hindfoot joints. An MRI is essential if surgery is being considered.


Non surgical Treatment

Conservative treatment also depends on the stage of the disease. Early on, the pain and swelling with no deformity can be treated with rest, ice, compression, elevation and non-steroidal anti-inflammatory medication. Usually OTC orthotic inserts are recommended with stability oriented athletic shoes. If this fails or the condition is more advanced, immobilization in a rigid walking boot is recommended. This rests the tendon and protects it from further irritation, attenuation, or tearing. If symptoms are greatly improved or eliminated then the patient may return to a supportive shoe. To protect the patient from reoccurrence, different types of devices are recommended. The most common device is orthotics. Usually custom-made orthotics are preferable to OTC. They are reserved for early staged PTTD. Advanced stages may require a more aggressive type orthotic or an AFO (ankle-foot orthosis). There are different types of AFO’s. One type has a double-upright/stirrup attached to a footplate. Another is a gauntlet-type with a custom plastic interior surrounded be a lace-up leather exterior. Both require the use of a bulky type athletic or orthopedic shoes. Patient compliance is always challenging with these larger braces and shoes.

Adult Acquired Flat Foot


Surgical Treatment

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.

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We all understand that running shoes offer the premium line of protection against future injuries during the marathon. Although most modern running shoes are those with cushioning. The second type running shoes is the motion control these shoes. You have a normal foot. Running shoe stores also often offer free running gait analysis that help identify flat feet, there are major types of footwear that are designed to help you. As a disclaimer, the video notes that the Nike Free Run 2 Australia and MensNIKE running shoes Free Run 2 will be launched. If your feet is high, the condition running shoes is known as pronation.

As one can seen above and although due to a variety of reasons, pain the ball of the foot is almost always treatable, and simple measures like proper shoe selection and shoe inserts can keep these conditions from returning. Some conditions do require surgery ultimately to relieve the pain, but this is not always the case as non-surgical treatment is quite successful in many cases at this part of the foot. The symptoms of over-pronation often depend on the age of the person, how much activity this person does and how serious the problem is. Knee, lower back and shin pain are some of the other symptoms of Over-Pronation.flat feet pain

The podiatrist will evaluate the entire lower extremity from hip to toe to determine if the child is experiencing any weakness or pain and to pinpoint the exact level where the deformity begins. Symptoms of flat foot can include pain in the foot , ankle or knee. The child may have a history of clumsiness, ask to be carried often or avoid physical activity. The doctor will take x-rays to evaluate the joints and alignment of the bones. Therefore, it is common for children to undergo physical therapy to learn stretches and exercises that target the calf muscles to allow for more normal biomechanics or foot function.

Flat feet are usually the result of one’s own genetics inherited from their family. Flattening is a normal part of the walking cycle of the foot , and in fact this is how the body disperses much of the shock forces created with walking. However, in some individuals, the foot flattens outward too much. This changes the way certain muscles in the foot and leg have to function, which causes numerous changes to the feet over time. These changes can include chronic straining of ligaments and tendons, as well as the development of deformities that rely on structural imbalance like bunions and hammertoes.

Parents are usually concerned when they notice that their child’s feet are flat Often, they take them to the doctor only to be told that their child will outgrow the deformity, which is often the case; however, in the instances when they don’t, they become more susceptible later in life to heel pain, arthritis and tendonitis. Treated early and aggressively, these conditions can be avoided in most cases. If your feet give you cause for worry, it is important that you consult with a foot care specialist, also known as a podiatrist. After undergoing basic tests, your doctor may prescribe anti-inflammatory medicine, orthotic insoles, and in severe cases, corrective surgery.