What Can cause Adult Aquired FlatFeet ?

Flat Feet

Overview

The posterior tibialis muscle originates on the bones of the leg (tibia and fibula). This muscle then passes behind the medial (inside) aspect of the ankle and attaches to the medial midfoot as the posterior tibial tendon. The posterior tibial tendon serves to invert (roll inward) the foot and maintain the arch of the foot. This tendon plays a central role in maintaining the normal alignment of the foot and also in enabling normal gait (walking). In addition to tendons running across the ankle and foot joints, a number of ligaments span and stabilize these joints. The ligaments at the medial ankle can become stretched and contribute to the progressive flattening of the arch. Several muscles and tendons around the ankle and foot act to counter-balance the action of the posterior tibial tendon. Under normal circumstances, the result is a balanced ankle and foot with normal motion. When the posterior tibial tendon fails, the other muscles and tendons become relatively over-powering. These muscles then contribute to the progressive deformity seen with this disorder.Adult Acquired Flat Feet


Causes

Overuse of the posterior tibial tendon is often the cause of PTTD. In fact, the symptoms usually occur after activities that involve the tendon, such as running, walking, hiking, or climbing stairs.


Symptoms

Pain and swelling around the inside aspect of the ankle initially. Later, the arch of the foot may fall (foot becomes flat), this change leads to walking to become difficult and painful, as well as standing for long periods. As the flat foot becomes established, pain may progress to the outer part of the ankle. Eventually, arthritis may develop.


Diagnosis

Observe forefoot to hindfoot alignment. Do this with the patient sitting and the heel in neutral, and also with the patient standing. I like to put blocks under the forefoot with the heel in neutral to see how much forefoot correction is necessary to help hold the hindfoot position. One last note is to check all joints for stiffness. In cases of prolonged PTTD or coalition, rigid deformity is present and one must carefully check the joints of the midfoot and hindfoot for stiffness and arthritis in the surgical pre-planning.


Non surgical Treatment

Because of the progressive nature of PTTD, early treatment is advised. If treated early enough, your symptoms may resolve without the need for surgery and progression of your condition can be arrested. In contrast, untreated PTTD could leave you with an extremely flat foot, painful arthritis in the foot and ankle, and increasing limitations on walking, running, or other activities. In many cases of PTTD, treatment can begin with non-surgical approaches that may include orthotic devices or bracing. To give your arch the support it needs, your foot and ankle surgeon may provide you with an ankle brace or a custom orthotic device that fits into the shoe. Immobilization. Sometimes a short-leg cast or boot is worn to immobilize the foot and allow the tendon to heal, or you may need to completely avoid all weight-bearing for a while. Physical therapy. Ultrasound therapy and exercises may help rehabilitate the tendon and muscle following immobilization. Medications. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, help reduce the pain and inflammation. Shoe modifications. Your foot and ankle surgeon may advise changes to make with your shoes and may provide special inserts designed to improve arch support.

Adult Acquired Flat Foot


Surgical Treatment

Surgical correction is dependent on the severity of symptoms and the stage of deformity. The goals of surgery are to create a more functional and stable foot. There are multiple procedures available to the surgeon and it may take several to correct a flatfoot deformity. Usually surgical treatment begins with removal of inflammatory tissue and repair of the posterior tibial tendon. A tendon transfer is performed if the posterior tibial muscle is weak or the tendon is badly damaged. The most commonly used tendon is the flexor digitorum longus tendon. This tendon flexes or moves the lesser toes downward. The flexor digitorum longus tendon is utilized due to its close proximity to the posterior tibial tendon and because there are minimal side effects with its loss. The remainder of the tendon is sutured to the flexor hallucis longus tendon that flexes the big toe so that little function is loss.

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The Leading Causes And Treatment Methods Of Achilles Tendinitis

Achilles Tendon

Overview

Achilles TendonAchilles tendinitis describes an inflammatory change of the Achilles tendon without a tear of the tendon. Achilles tendinitis may be acute or chronic. The onset of pain is usually unilateral but may be found bilaterally. Achilles tendinitis is common in the third or fourth decade of life in patients who are active with sports or in jobs that require physical labor. Pain is described at the insertion of the tendon in the heel bone or in the body of the tendon.

Causes

The two most common causes of Achilles tendonitis are Lack of flexibility and Overpronation. Other factors associated with Achilles tendonitis are recent changes in footwear, and changes in exercise training schedules. Often long distance runners will have symptoms of Achilles tendonitis after increasing their mileage or increasing the amount of hill training they are doing. As people age, tendons, like other tissues in the body, become less flexible, more rigid, and more susceptible to injury. Therefore, middle-age recreational athletes are most susceptible to Achilles tendonitis.

Symptoms

The onset of the symptoms of Achilles tendonitis tend to be gradual, with symptoms usually developing over a period of several days, or even weeks. Symptoms may include, Pain, this may be mild at first and may only be noticeable after exercise. Over time the pain may become constant and severe. Stiffness, this is usually relieved by activity. Sluggishness in the leg. Tenderness, particularly in the morning and most commonly felt just above where the tendon attaches to the heel bone. Swelling.

Diagnosis

To confirm the diagnosis and consider what might be causing the problem, it?s important to see your doctor or a physiotherapist. Methods used to make a diagnosis may include, medical history, including your exercise habits and footwear, physical examination, especially examining for thickness and tenderness of the Achilles tendon, tests that may include an x-ray of the foot, ultrasound and occasionally blood tests (to test for an inflammatory condition), and an MRI scan of the tendon.

Nonsurgical Treatment

The aim, when treating Achilles tendinitis, is to relieve pain and reduce swelling. The kind of treatment used can vary, based on the severity of the condition and whether or not the patient is a professional athlete. After diagnosis, the doctor will decide which method of treatment is required for the patient to undergo, it is likely that they will suggest a combination. Stretching achilles tendon, a doctor might show the patient some stretching exercises that help the Achilles tendon heal, as well as preventing future injury. Methods used to treat Achilles tendinitis include, ice packs – applying these to the tendon, when in pain or after exercising, can alleviate the pain and inflammation. Resting, this gives the tissue time to heal. The type of rest needed depends on the severity of the symptoms. In mild cases of Achilles tendinitis, it may mean just reducing the intensity of a workout, in severe cases it might mean complete rest for days or weeks. Elevating the foot, swelling can be reduced if the foot is kept raised above the level of the heart. Exercise and stretching, a doctor might show the patient some stretching exercises that help the Achilles tendon heal, as well as preventing future injury. They may, instead, refer the patient to a physiotherapist or another specialist. The exercises learned will improve the flexibility of the area and likely increase calf strength. Pain relievers – non-steroidal anti-inflammatory drugs (NSAIDS), such as ibuprofen can reduce pain and swelling. If you suffer from asthma, kidney disease or liver disease do not take NSAIDs without first checking with your doctor. Steroid injections, these can reduce tendon swelling, but should be performed with caution, as this process has been associated with a greater risk of tendon rupture. A doctor would likely perform the injection while scanning the area with ultrasound to reduce this risk. Compression bandages and orthotic devices, such as ankle supports and shoe inserts can aid recovery as they take the stress off the Achilles tendon.

Achilles Tendinitis

Surgical Treatment

Surgery can be done to remove hardened fibrous tissue and repair any small tendon tears as a result of repetitive use injuries. This approach can also be used to help prevent an Achilles tendon rupture. If your Achilles tendon has already ruptured or torn, Achilles tendon surgery can be used to reattach the ends of the torn tendon. This approach is more thorough and definitive compared to non surgical treatment options discussed above. Surgical reattachment of the tendon also minimizes the change of re-rupturing the Achilles tendon.

Prevention

You can take measures to reduce your risk of developing Achilles Tendinitis. This includes, Increasing your activity level gradually, choosing your shoes carefully, daily stretching and doing exercises to strengthen your calf muscles. As well, applying a small amount ZAX?s Original Heelspur Cream onto your Achilles tendon before and after exercise.