We often think of fallen arches as a cause of foot pain, but they also stress your spine. In fact, fallen arches often contribute to unresolved or recurrent back pain. Excessive foot pronation (rolling in) can produce a short leg, pelvic unleveling, and increased curvature in your spine. Fallen arches place stress and strain on your feet, knees, hips, and spine. A custom orthotic can be a key part of your treatment plan in helping you get rid of your pain.
A fallen arch occurs because one of the main structures that support the arch has broken or torn. Usually it occurs without trauma, although a small injury associated with the onset of the pain is often recalled, it is sometimes difficult to determine whether the injury was clearly big enough to permanently injure the leg. I suspect that even before the symptoms that the structure that broke was weakening and the injury was simply the ?needle that broke the camels back?. The structure that is most commonly torn is the posterior tibial tendon. This tendon is attached to a muscle on the inside of the back of the ankle, and runs along the medial malleolus, the bony prominence on the inside of the ankle, to attach to a bone in the arch called the navicular bone. It usually begins to weaken and stretch along the back of the medial malleolus. It often begins as a swelling and the arch flattens over the next several weeks to months. As the arch flattens, other structures that support the arch begin to stretch and tear. The bones along the outside of the ankle begin to crush together, causing pain and swelling in this are, and the toes may tilt to the outside as the arch collapses. It is not known why this process begins. It is often associated with diabetes and rheumatoid arthritis and other inflammatory diseases. It also is more common as a person enters the fifty to seventy year age range. ?Fallen arches? are much more common in people who are already flat footed.
Many people have flat feet and notice no problems and require no treatment. But others may experience the following symptoms, Feet tire easily, painful or achy feet, especially in the areas of the arches and heels, the inside bottom of your feet become swollen, foot movement, such as standing on your toes, is difficult, back and leg pain, If you notice any of these symptoms, it's time for a trip to the doctor.
You can test yourself to see if you have flat feet or fallen arches by using a simple home experiment. First, dip your feet in water. Then step on a hard flat surface, like a dry floor or a piece of paper on the floor, where your footprints will show. Step away and examine your foot prints. If you see complete/full imprints of your feet on the floor, you may have fallen arches. However, it?s important to seek a second option from a podiatrist if you suspect you have fallen arches so they can properly diagnose and treat you.
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Non Surgical Treatment
If you have flat feet (pes planus) it does not mean you will have problems or pain. Flat feet are a common condition. Flat feet are defined as an abnormal lowering of the medial longitudinal arch. There is often a hereditary component to the development of flat feet. Flat feet are more common in certain ethnic groups. Flat feet usually occurs equally in both feet and become apparent at an early age. Flat feet can initially be asymptomatic, but can become progressively symptomatic with age. Some flat feet never become bothersome. The medial arch is unstable in flexible flatfoot. The foot can bend as the heel lifts of the ground. This creates stress on the surrounding soft-tissues and joints creating tired, sore arches. The instability of the foot can create abnormal stress that flows up the leg which results in pain in the legs, knees, hips and lower back. Patients with flat feet often present to the chiropodist/podiatrist with problems that are indirectly caused by their foot structure.
A combination of surgical procedures can be used to reconstruct the flatfoot. Generally, these procedures can be separated into those that correct deformities of the bones and those that repair ligaments and tendons. Your orthopaedic surgeon will choose the proper combination of procedures for your foot. Surgery of the foot can be performed under regional anesthesia, which is numbing the foot and ankle with a nerve or spinal block, or general anesthesia, which may require a breathing tube. A nerve block is often placed behind the knee to reduce pain after surgery.
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.