03 juillet 2017 ~ 0 Commentaire

Fallen Arches What To Expect

Overview

Acquired Flat Feet

Fallen arches, or flatfoot, is a condition in which the arch on the inside of the foot is flat and the entire sole of the foot rests on the ground. It affects about 40 percent of the general population. Although flat feet in and of themselves are not usually problematic, they can create problems in the feet, hips, ankles and knees. Pain may be experienced in the lower legs if there are alignment problems and if the individual is engaged in a lot of heavy, high-impact activities that put stress on the bones and muscles of the lower legs.

Causes

When flat feet develop at a later age, they are known as fallen arches. The arches may fall because the muscles supporting them are no longer able to do so. In addition the spring ligament within the foot may have lost some of its tension allowing the arch of the foot to flatten. Other conditions causing fallen arches include sudden weight gain, a nervous system injury, or a loss of sensation caused by a disease such as diabetes. Most people with fallen arches are flat on both feet.

Symptoms

Most people do not exhibit any symptoms of flat feet, but if the condition is due to an underlying problem, symptoms can include foot pain, mainly in the arch or heel areas, difficulty standing on tiptoes, swelling that occurs on the inside of the ankle, pain in the calf, knee, hip, or lower leg area, both feet lie flat on the ground with no gap, Shoes may not fit properly, heel may tilt away from the midline of the body more than usual, absence of foot arch when standing. If you are experiencing these symptoms and have flat feet, you should consider seeing your doctor or a podiatrist immediately for an examination.

Diagnosis

An examination of the foot is enough for the health care provider to diagnose flat foot. However, the cause must be determined. If an arch develops when the patient stands on his or her toes, the flat foot is called flexible and no treatment or further work-up is necessary. If there is pain associated with the foot or if the arch does not develop with toe-standing, x-rays are necessary. If a tarsal coalition is suspected, a CT scan is often ordered. If a posterior tibial tendon injury is suspected, your health care provider may recommend an MRI.

arch support for flat feet

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 health care provider. 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

Adult Acquired Flat Feet

This is rare and usually only offered if patients have significant abnormalities in their bones or muscles. Treatments include joint fusion, reshaping the bones in the foot, and occasionally moving around tendons in the foot to help balance out the stresses (called tendon transfer). Flat feet and fallen arches are common conditions that are in most cases asymptomatic. However, in patients who do have symptoms, treatments are available that can help reduce pain and promote efficient movement. Orthotic devices are well recognised as an excellent treatment and podiatrists can offer these different treatment modalities as individualised treatments for patients.

After Care

Patients may go home the day of surgery or they may require an overnight hospital stay. The leg will be placed in a splint or cast and should be kept elevated for the first two weeks. At that point, sutures are removed. A new cast or a removable boot is then placed. It is important that patients do not put any weight on the corrected foot for six to eight weeks following the operation. Patients may begin bearing weight at eight weeks and usually progress to full weightbearing by 10 to 12 weeks. For some patients, weightbearing requires additional time. After 12 weeks, patients commonly can transition to wearing a shoe. Inserts and ankle braces are often used. Physical therapy may be recommended. There are complications that relate to surgery in general. These include the risks associated with anesthesia, infection, damage to nerves and blood vessels, and bleeding or blood clots. Complications following flatfoot surgery may include wound breakdown or nonunion (incomplete healing of the bones). These complications often can be prevented with proper wound care and rehabilitation. Occasionally, patients may notice some discomfort due to prominent hardware. Removal of hardware can be done at a later time if this is an issue. The overall complication rates for flatfoot surgery are low.

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