Have you noticed that one or both of your feet are starting to flatten? Have you started to develop swelling, warmth and/or pain to the inside or outside of your ankle without any reason that you can remember? If so than you could be experiencing Adult Acquired Flat Foot. Adult acquired flat foot is usually due to a weakening of a large tendon that starts in the lower leg, runs along the inside of your ankle and then attaches itself to the inner arch of your foot. This tendon is called the Posterior Tibial Tendon. Its main purpose is to help support the arch and balance the inside of your foot during stance and gait. This tendon can become inflamed with an acute injury, recent weight gain or from everyday use if your foot is not in supportive shoes. This is usually a progressive condition that will continue to worsen if left untreated. The tendon will slowly lose its function as it becomes further and further stretched. As this happens, your arch will fall, your toes may point outward and your midfoot/ankles may roll inward. Eventually the tendon may provide no function at all and you may begin to develop adaptive arthritis in the surrounding joints of your foot and ankle.
To help diagnose this condition, we will ask you about your medical history, perform a lower extremity physical exam and usually obtain X-rays of the foot and ankle to help rule out other possible causes for your pain. Once the diagnosis is made the treatment course begins conservatively. Usually a round of Non Steroidal Anti-Inflammatory Drugs (NSAIDS) such as Ibuprofen, Aleve or Motrin is started to help decrease the inflammation. You will also begin wearing either a supportive insole or be placed in a walking boot or ankle brace depending on your symptoms. Insoles, ankle braces and walking boots are great option because they will help suspend the arch, hold your foot in its correct position and take strain off of the posterior tibial tendon. This will allow the foot, ankle and lower leg to rest and relax. Other treatment modalities that can be used during this time are physical therapy and use of cold lasers to help reduce inflammation, pain and swelling. In rare circumstances when conservative treatments have failed, surgery may be needed to repair the tendon and possibly realign the foot if severe arthritis has permanently altered your foot structure.
The doctors at Advanced Foot and Ankle Center have comprehensive training in adult acquired flat foot and are here to serve you. Please call with any questions you may have.
Eric Silvers, DPM
Dustin Lloyd, DPM
Christopher Witt, DPM