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What Is Pes Planus

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Overview<br><br>Flat feet and fallen arches refer to the same thing. It's a downward sagging of the inside edge of the foot during standing or walking. The front-to-back arches (called the longitudinal arches) are natural curves along the bottoms of both feet that are supported by muscles and ligaments. When these muscles and ligaments give way, the arches sag with each step. When the arches sag, your weight is shifted toward your big toes.<br><br>Causes<br>Just as there are many different causes of flat feet, there are also many different treatment options. The most important aspect of treatment is determining the exact type or underlying cause of flat feet that you have. Foot and ankle specialists can determine this through thorough clinical examination and special imaging studies (e.g., x-rays, computed tomography, and/or magnetic resonance imaging). Conservative treatment is effective in the vast majority of flat foot cases, and consists of things such as insoles, splints, manipulation, or casting. Surgery is required [http://world-america.info/user/TeresaGrasby4/ How much does it cost to lengthen your legs?] less frequently, and is reserved only for some of the severe types of flat foot that do not respond to conservative therapy. You may have noticed that one common element in the conservative treatment of all types of flat feet is orthoses. Many companies now manufacture semi-custom orthotic devices that not only improve comfort, but also seek to control abnormal motion of the foot. These over-the-counter inserts, in the $25 to $50 range, are an economical treatment that may help a majority of people. Unfortunately, these semi-custom devices will not fit everyone perfectly, and those of us who differ too much from the average may respond better to custom orthotic devices. Custom inserts are prescribed by your foot and ankle specialist and are made individually from either a physical or computerized impression of your feet. The only drawback of custom orthoses is their cost, ranging anywhere from $300 to $500. Many physicians recommend trying over-the-counter inserts first (and even keep them in stock) as they may save their patients large sums of money.<br><br>Symptoms<br>Depending on the cause of the flatfoot, a patient may experience one or more of the different symptoms below. Pain along the course of the posterior tibial tendon which lies on the inside of the foot and ankle. This can be associated with swelling on the inside of the ankle. Pain that is worse with activity. High intensity or impact activities, such as running, can be very difficult. Some patients can have difficulty walking or even standing for long periods of time. When the foot collapses, the heel bone may shift position and put pressure on the outside ankle bone (fibula). This can cause pain on the outside of the ankle. Arthritis in the heel also causes this same type of pain. Patients with an old injury or arthritis in the middle of the foot can have painful, bony bumps on the top and inside of the foot. These make shoewear very difficult. Occasionally, the bony spurs are so large that they pinch the nerves which can result in numbness and tingling on the top of the foot and into the toes. Diabetics may only notice swelling or a large bump on the bottom of the foot. Because their sensation is affected, people with diabetes may not have any pain. The large bump can cause skin problems and an ulcer (a sore that does not heal) may develop if proper diabetic shoewear is not used.<br><br>Diagnosis<br>If your child has flatfeet, his or her doctor will ask about any family history of flatfeet or inherited foot problems. In a person of any age, the doctor will ask about occupational and recreational activities, previous foot trauma or foot surgery and the type of shoes worn. The doctor will examine your shoes to check for signs of excessive wear. Worn shoes often provide valuable clues to gait problems and poor bone alignment. The doctor will ask you to walk barefoot to evaluate the arches of the feet, to check for out-toeing and to look for other signs of poor foot mechanics. The doctor will examine your feet for foot flexibility and range of motion and feel for any tenderness or bony abnormalities. Depending on the results of this physical examination, foot X-rays may be recommended. X-rays are always performed in a young child with rigid flatfeet and in an adult with acquired flatfeet due to trauma.<br><br>Non Surgical Treatment<br>What we want to do is support the arch and maintain it in that curved position. So what you want is to bring the foot into a position where you hold and support the arch so you can get that correct heel-midfoot-big toe contact. You would achieve that with a level of arch support. People will take different levels of support, if you?re somebody who has movement in your arch, a strong level of support will hold and maintain you whereas if you?re someone whose arch has collapsed it could need more support and a level of correction built into the support to realign you. If you think of it, when your arch drops, it affects your foot but it also has a biomechanical effect on the rest of the body. But nothing that can?t be solved.<br><br>Surgical Treatment<br><br>Generally one of the following procedures is used to surgically repair a flat foot or fallen arch. Arthrodesis. One or more of your bones in the foot or ankle are fused together. Osteotomy. Correcting alignment by cutting and reshaping a bone. Excision. Removing a bone or a bone spur. Synovectomy. Cleaning the sheath that covers the tendon. Tendon transfer. Using a piece of one tendon to lengthen or replace another. Arthroereisis. placing a small device in the subtalar joint to limit motion. For most people, treatment is successful, regardless of the cause, although the cause does does play a major role in determining your prognosis. Some causes do not need treatment, while others require a surgical fix.<br><br>Prevention<br>Going barefoot, particularly over terrain such as a beach where muscles are given a good workout, is good for all but the most extremely flatfooted, or those with certain related conditions such as plantar fasciitis. Ligament laxity is also among the factors known to be associated with flat feet. One medical study in India with a large sample size of children who had grown up wearing shoes and others going barefoot found that the longitudinal arches of the bare footers were generally strongest and highest as a group, and that flat feet were less common in children who had grown up wearing sandals or slippers than among those who had worn closed-toe shoes. Focusing on the influence of footwear on the prevalence of pes planus, the cross-sectional study performed on children noted that wearing shoes throughout early childhood can be detrimental to the development of a normal or a high medial longitudinal arch. The vulnerability for flat foot among shoe-wearing children increases if the child has an associated ligament laxity condition. The results of the study suggest that children be encouraged to play barefooted on various surfaces of terrain and that slippers and sandals are less harmful compared to closed-toe shoes. It appeared that closed-toe shoes greatly inhibited the development of the arch of the foot more so than slippers or sandals. This conclusion may be a result of the notion that intrinsic muscle activity of the arch is required to prevent slippers and sandals from falling off the child?s foot.<br><br>After Care<br>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.
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Overview<br><br>Fallen arches are a condition of the feet that can cause pain and discomfort. Normally, you should see an arch in the bottom of your foot. That arch is created by the tendons in your feet. The tendons pull, which forms the arch. Sometimes, the tendons do not pull as they should, which results in the condition of fallen arches. If you have fallen arches, your feet may look flat. You might also notice when you see your bare footprint that the arch is not visible in the print. It is fairly common for children to have flat feet, but the arch usually develops as it should as they get older. For adults, fallen arches can be quite painful and problematic.<br><br>Causes<br>Flat feet are a common condition. In infants and toddlers, the arch is not developed and flat feet are normal. The arch develops in childhood. By adulthood, most people have developed normal arches. When flat feet persist, most are considered variations of normal. Most feet are flexible and an arch appears when the person stands on his or her toes. Stiff, inflexible, or painful flat feet may be associated with other conditions and require attention. Painful flat feet in children may be caused by a condition called tarsal coalition. In tarsal coalition, two or more of the bones in the foot fuse together. This limits motion and often leads to a flat foot. Most flat feet do not cause pain or other problems. Flat feet may be associated with pronation, in which the ankle bones lean inward toward the center line. When the shoes of children who pronate are placed side by side, they will lean toward each other (after they have been worn long enough for the foot position to remodel their sole). Foot pain, ankle pain, or lower leg pain (especially in children) may be a result of flat feet and should be evaluated by a health care provider. Adults can develop a flat foot when they are 60 - 70 years old. This type of flat foot is usually on one side.<br><br>Symptoms<br>Depending on the cause of the flatfoot, a patient may experience one or more of the different symptoms below. Pain along the course of the posterior tibial tendon which lies on the inside of the foot and ankle. This can be associated with swelling on the inside of the ankle. Pain that is worse with activity. High intensity or impact activities, such as running, can be very difficult. Some patients can have difficulty walking or even standing for long periods of time. When the foot collapses, the heel bone may shift position and put pressure on the outside ankle bone (fibula). This can cause pain on the outside of the ankle. Arthritis in the heel also causes this same type of pain. Patients with an old injury or arthritis in the middle of the foot can have painful, bony bumps on the top and inside of the foot. These make shoewear very difficult. Occasionally, the bony spurs are so large that they pinch the nerves which [http://bbs.klyk.cn/home.php?mod=space&uid=81632&do=profile&from=space Can you get an operation to make you taller?] result in numbness and tingling on the top of the foot and into the toes. Diabetics may only notice swelling or a large bump on the bottom of the foot. Because their sensation is affected, people with diabetes may not have any pain. The large bump can cause skin problems and an ulcer (a sore that does not heal) may develop if proper diabetic shoewear is not used.<br><br>Diagnosis<br>Your doctor will ask about your symptoms and medical history. A physical and foot exam will be done. Flat feet can be diagnosed by appearance. To determine if the foot is rigid, you may be asked to do some simple tasks.<br><br>Non Surgical Treatment<br>Ligaments hold up arches. Deformed ligaments will not return to their original shape, just as an overstretched rubber band remains elongated. Arch supports help restore more normal function. Not all orthotics are made alike. Sole Supports custom designed orthotics are unique in the way they are cast. Sole Supports compensate for the differences between each foot. They take into account your body weight and the degree of flexibility in your feet. Taking care of fallen arches can be key in dealing with unresolved or recurrent back pain.<br><br>Surgical Treatment<br><br>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.<br><br>After Care<br>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.

Latest revision as of 09:51, 8 October 2017

Overview

Fallen arches are a condition of the feet that can cause pain and discomfort. Normally, you should see an arch in the bottom of your foot. That arch is created by the tendons in your feet. The tendons pull, which forms the arch. Sometimes, the tendons do not pull as they should, which results in the condition of fallen arches. If you have fallen arches, your feet may look flat. You might also notice when you see your bare footprint that the arch is not visible in the print. It is fairly common for children to have flat feet, but the arch usually develops as it should as they get older. For adults, fallen arches can be quite painful and problematic.

Causes
Flat feet are a common condition. In infants and toddlers, the arch is not developed and flat feet are normal. The arch develops in childhood. By adulthood, most people have developed normal arches. When flat feet persist, most are considered variations of normal. Most feet are flexible and an arch appears when the person stands on his or her toes. Stiff, inflexible, or painful flat feet may be associated with other conditions and require attention. Painful flat feet in children may be caused by a condition called tarsal coalition. In tarsal coalition, two or more of the bones in the foot fuse together. This limits motion and often leads to a flat foot. Most flat feet do not cause pain or other problems. Flat feet may be associated with pronation, in which the ankle bones lean inward toward the center line. When the shoes of children who pronate are placed side by side, they will lean toward each other (after they have been worn long enough for the foot position to remodel their sole). Foot pain, ankle pain, or lower leg pain (especially in children) may be a result of flat feet and should be evaluated by a health care provider. Adults can develop a flat foot when they are 60 - 70 years old. This type of flat foot is usually on one side.

Symptoms
Depending on the cause of the flatfoot, a patient may experience one or more of the different symptoms below. Pain along the course of the posterior tibial tendon which lies on the inside of the foot and ankle. This can be associated with swelling on the inside of the ankle. Pain that is worse with activity. High intensity or impact activities, such as running, can be very difficult. Some patients can have difficulty walking or even standing for long periods of time. When the foot collapses, the heel bone may shift position and put pressure on the outside ankle bone (fibula). This can cause pain on the outside of the ankle. Arthritis in the heel also causes this same type of pain. Patients with an old injury or arthritis in the middle of the foot can have painful, bony bumps on the top and inside of the foot. These make shoewear very difficult. Occasionally, the bony spurs are so large that they pinch the nerves which Can you get an operation to make you taller? result in numbness and tingling on the top of the foot and into the toes. Diabetics may only notice swelling or a large bump on the bottom of the foot. Because their sensation is affected, people with diabetes may not have any pain. The large bump can cause skin problems and an ulcer (a sore that does not heal) may develop if proper diabetic shoewear is not used.

Diagnosis
Your doctor will ask about your symptoms and medical history. A physical and foot exam will be done. Flat feet can be diagnosed by appearance. To determine if the foot is rigid, you may be asked to do some simple tasks.

Non Surgical Treatment
Ligaments hold up arches. Deformed ligaments will not return to their original shape, just as an overstretched rubber band remains elongated. Arch supports help restore more normal function. Not all orthotics are made alike. Sole Supports custom designed orthotics are unique in the way they are cast. Sole Supports compensate for the differences between each foot. They take into account your body weight and the degree of flexibility in your feet. Taking care of fallen arches can be key in dealing with unresolved or recurrent back pain.

Surgical Treatment

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.

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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