Some people have always had flat feet
from a young age. Unfortunately as people reach their fifties they will suddenly have one foot with
a flatter arch than the other foot. This situation is termed adult acquired flatfoot. Adult acquired flatfoot is a painful condition occurring in one foot. The common patient profile is a female over
the age of 50 with pre-existing flatfeet, high blood pressure, high cholesterol, diabetes and obesity. All of these underlying problems will lead to a weakening of the support structures of the arch.
If you have adult acquired flat foot you will not be able to lift your heel off the ground while standing on one leg. Adult acquired flatfoot may develop due to trauma or degeneration of major
tendons ankle & foot. Weakness or paralysis of leg muscles can also create a flatfoot deformity.
There are a number of theories as to why the tendon becomes inflamed and stops working. It may be related to the poor blood supply within the tendon. Increasing age, inflammatory arthritis, diabetes
and obesity have been found to be causes.
Your feet tire easily or become painful with prolonged standing. It's difficult to move your heel or midfoot around, or to stand on your toes. Your foot aches, particularly in the heel or arch area,
with swelling along the inner side. Pain in your feet reduces your ability to participate in sports. You've been diagnosed with rheumatoid arthritis; about half of all people with rheumatoid
arthritis will develop a progressive flatfoot deformity.
Examination by your foot and ankle specialist can confirm the diagnosis for most patients. An ultrasound exam performed in the office setting can evaluate the status of the posterior tibial tendon,
the tendon which is primarily responsible for supporting the arch structure of the foot.
Non surgical Treatment
Nonoperative therapy for posterior tibial tendon dysfunction has been shown to yield 67% good-to-excellent results in 49 patients with stage 2 and 3 deformities. A rigid UCBL orthosis with a medial
forefoot post was used in nonobese patients with flexible heel deformities correctible to neutral and less than 10? of forefoot varus. A molded ankle foot orthosis was used in obese patients with
fixed deformity and forefoot varus greater than 10?. Average length of orthotic use was 15 months. Four patients ultimately elected to have surgery. The authors concluded that orthotic management is
successful in older low-demand patients and that surgical treatment can be reserved for those patients who fail nonoperative treatment.
A new type of surgery has been developed in which surgeons can re-construct the flat foot deformity and also the deltoid ligament using a tendon called the peroneus longus. A person is able to
function fully without use of the peroneus longus but they can also be taken from deceased donors if needed. The new surgery was performed on four men and one woman. An improved alignment of the
ankle was still evident nine years later, and all had good mobility 8 to 10 years after the surgery. None had developed arthritis.