Shaunna Camerano

Foot Difficulties Explained

Do Fallen Arches Need Surgery?

Overview

Acquired Flat Foot

Flat feet, fallen arches, or ?pes planus? is normally a symptomless and fortunately painless condition. It is characterized by the arch of the foot collapsing completely, which causes the entire sole of the foot to come into perfect contact with the ground. An estimated 20-30 percent of the entire population has some form of flat feet, ranging in severity from asymptomatic to somewhat problematic. Most people who endure this problem are able to experience life pain and symptom free from the nearly unnoticeable abnormality. However, a small sector of those affected do experience pain or discomfort, which is when a treatment program needs to be put in action.

Causes

Some people develop fallen arches because they tend to pronate, or roll inwards on the ankles, says the Instep Foot Clinic. Other people may simply have under-developed muscles in their arches. Your arches help your feet bear weight and are supported in this job by muscles and tendons in your feet and ankles. So, while fallen arches aren?t usually serious, they can cause pain in your feet, ankles, knees and/or hips due to your reduced weight-bearing ability. In these cases, treatment may be required. Orthotics that sit in your shoes and support your arches are a common solution, as are exercises to strengthen and stretch your feet and leg muscles.

Symptoms

Flat feet may not cause any symptoms at all. Rigid flat feet may cause pain, calluses, blisters, or skin redness on the inner side of the foot. A stiff foot, weakness or numbness of the foot, Rapid wearing out of shoes-worn shoes lean in toward each other. Difficulty or pain with activities like running-in the foot, knee or hip.

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.

arch supports for high arches

Non Surgical Treatment

Some of the aspects of the pain with a ?fallen arch? are related to the crushing of the joints of the outside of the foot and from the stretching of ligaments and tendons of the inside of the foot. Unfortunately, some parts of the damage from the fallen arch, the weakness in the tendons and the new shape of the foot, are not correctable without surgical reconstruction. The first goal is to stabilize the collapsed arch. This can be done through braces. If the deformity is mild, an over-the-counter arch support may be sufficient. In more severe deformities an hinged or solid ankle brace may be necessary. Rehabilitative exercises under the supervision of a physical therapist will help increase the strength of the remaining muscles. Stiffness of certain tendons including the Achilles and hamstring is also very helpful as tightness in these structures is very common in people with ?fallen arches?. Postural training is necessary. A short period of casting or walking in a cast boot will improve swelling of a recent partial tear of the tendons and ligaments on the inside of the ankle. Nonsteroidal anti-inflammatory medications such as ibuprofen, and naprosyn can help to relieve the pain, but do not heal the injuries associated with this or decrease the swelling significantly. Surgical reconstruction is available if the pain cannot be controlled reasonably with these measures.

Surgical Treatment

Adult Acquired Flat Foot

In cases of flat feet that have progressed substantially or have failed to improve with non-surgical treatment, surgery may be required and in some advanced cases, surgery may be the only option. Your foot and ankle surgeon will determine the best approach for you.

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.
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