Posterior tibial tendon dysfunction is one of the most common problems of the foot and ankle. It occurs when the posterior tibial tendon becomes inflamed or torn. As a result, the tendon may not be able to provide stability and support for the arch of the foot, resulting in flatfoot. The posterior tibial tendon is one of the most important tendons of the leg. A tendon attaches muscles to bones, and the posterior tibial tendon attaches the calf muscle to the bones on the inside of the foot. The main function of the tendon is to hold up the arch and support the foot when walking. The posterior tibial tendon serves as one of the major supporting structures of the foot, helping it to function while walking. Posterior tibial tendon dysfunction (PTTD) is a condition caused by changes in the tendon, impairing its ability to support the arch. This results in flattening of the foot. PTTD is often called "adult acquired flatfoot" because it is the most common type of flatfoot developed during adulthood. Although this condition typically occurs in only one foot, some people may develop it in both feet. PTTD is usually progressive, which means it will keep getting worse, especially if it isn't treated early.
Flat feet are often a congenital problem which has no specific cause. They can however occur after an injury, especially conditions such as Tibialis Posterior Syndrome or more traumatic injuries such as fractures or mid-tarsal joint sprains. The other thing to look out for is Overpronation. Often this is confused with having flat feet (or a fallen arch) although it is not technically the same thing. If an individual does not have flat feet but does overpronate then the arch of their foot appears to be normal when standing. However, when they walk the arch collapses and the foot rolls in excessively. This is more difficult to spot than flat feet. It is estimated that between 60 and 80% of the population overpronate!
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.
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.
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Non Surgical Treatment
There are home remedies to prevent or manage pain from fallen arches or flat feet. Here are some areas to consider. Wear footwear or shoe inserts that are appropriate to your activity. When pain occurs, try at-home treatment of rest, ice, and over-the-counter nonsteroidal anti-inflammatories, or NSAIDS, such as ibuprofen. Ask your doctor or a physical therapist to show you stretches that can prepare you for feet-intensive activities. Limit or treat risk factors that can make fallen arches or flat feet worse, such as diabetes, high blood pressure, and obesity. Avoid activities that put excessive stress on your feet, such as running on roads. Avoid high-impact sports such as basketball, hockey, soccer, and tennis. Know when to get help. When pain is severe or interferes with activities, it's time to see the doctor for a thorough exam and treatment.
A better approach is to strengthen the weakened ligaments with Prolotherapy, supplemented by an arch support if the condition has existed for several years. Chronic pain is most commonly due to tendon and ligament weakness, or cartilage deterioration. The safest and most effective natural medicine treatment for repairing tendon, ligament and cartilage damage is Prolotherapy. In simple terms, Prolotherapy stimulates the body to repair painful areas. It does so by inducing a mild inflammatory reaction in the weakened ligaments and cartilage. Since the body heals by inflammation, Prolotherapy stimulates healing. Prolotherapy offers the most curative results in treating chronic pain. It effectively eliminates pain because it attacks the source: the fibro-osseous junction, an area rich in sensory nerves. What?s more, the tissue strengthening and pain relief stimulated by Prolotherapy is permanent.
Well-fitted shoes with good arch support may help prevent flat feet. Maintaining a healthy weight may also lower wear and tear on the arches.
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.