Do Fallen Arches Necessitate Surgery?

Overview

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A ?fallen arch? is a change in the shape of the foot. The normal gap between the floor and the arch on the inside of the foot narrows. It is usually painful, sometimes cripplingly painful and crippling. The heel leans to the inside, giving the inner ankle a bowed appearance. The joints of the outside of the crush together causing pain and swelling. The ligaments on the inside of the ankle stretch causing additional pain. Over time, the joints of the midfoot and forefoot adapt to the tilting of the ankle so that the front of the foot remains on the floor, complicating the deformity.

Causes

There are many reasons why flat feet develop. Here?s a look at some of the most common causes. Genetics, weak arches, injury, arthritis, diabetes, age, wear and tear on feet, tibialis posterior (ruptured tendon). Nervous system or muscle diseases such as cerebral palsy. Weakness and tightness of other muscles and tendons higher up in the lower extremity. The way our arches form depends on several factors. Our feet are complex structures that comprise twenty-six bones, thirty-three joints, and more than 100 muscles, tendons, and ligaments each. Each foot forms two arches. The arch that runs from the heel to the toe is known as the longitudinal arch, while the one that runs the width is known as the transverse arch. Ligaments (fibrous tissues) give our arches their shape and hold our bones together. The plantar fascia (the long, strong band of connective tissue that runs along the sole of your foot) and muscles add secondary support. There are also foot pads that absorb impact and assist with weight-bearing functions. How these things intertwine and work together determines the formation of our arches. A structural abnormality or injury to one of these components can result in flatfoot.

Symptoms

It?s possible to have fallen arches and experience no symptoms whatsoever. But many people do notice some problems with this condition. Their feet, back and legs ache. Standing on their toes is difficult, if not impossible, and they note swelling around the arch and heel.

Diagnosis

You can always give yourself the ?wet test? described above to see whether you have flat feet. Most people who do not notice their flat feet or have no pain associated with them do not think to see a foot doctor. Flat feet can lead to additional problems such as stiffness or pain, however, especially if the condition appears out of nowhere. If you think you may have flat feet, you should seek medical attention to ensure there are no additional issues to worry about. Your doctor will be able to diagnose you with a number of tests. For example, he or she may have you walk around, stand still, or stand on your tiptoes while you are being examined. Your doctor may also examine your foot?s shape and functionality. It?s important to let your foot doctor know about your medical and family history. In some cases, your doctor may order imaging tests such as x-rays or an MRI (magnetic resonance imaging) to determine a cause of your flat foot. If tarsal coalition is suspected in children, a CT scan is often ordered.

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Non Surgical Treatment

If your condition is bothersome, try elevating your feet and using ice on the arches to reduce swelling. Your podiatrist can recommend several orthotic aids and inserts to strengthen the tendons of your foot. He can also demonstrate stretching exercises or refer you to physical therapy to get those tendons back into shape. If the symptoms of fallen arches are painful and troubling, he may recommend a steroid injection to relieve inflammation and pain. And in some instances, he may determine that surgery is necessary.

Surgical Treatment

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Surgical procedures for flat feet vary depending on the root cause of the condition. Surgical correction to control pronation may include bone implants or Achilles tendon lengthening. Tendon transfer, which is a procedure to re-attach a tendon to another area of bone, may also be used to reduce pronation and improve foot function.