Simonne Henegar

How You Can Diagnose Inferior Calcaneal Spur

9/24/2015

Overview

A heel spur is a projection or growth of bone where certain muscles and soft tissue structures of the foot attach to the bottom of the heel. Most commonly, the plantar fascia, a broad, ligament-like structure extending from the heel bone to the base of the toes becomes inflamed, and symptoms of heel pain begin. As this inflammation continues over a period of time, with or without treatment, a heel spur is likely to form. If heel pain is treated early, conservative therapy is often successful, and surgery is usually avoided.

Causes

There exists a membrane that covers most of the bone along the heel. When this membrane gets torn repeatedly due to straining of the muscles in the foot, the calcium deposits that lead to heel spurs are more likely to occur.

Inferior Calcaneal Spur

Symptoms

Although it may take years to become a problem, once it appears, it may cause considerable suffering. Because of proximity to the tendons, the spur is a source of continuous painful aching. The sensation has been described as "a toothache in the foot." When you place your weight on the heel, the pain can be sufficient to immobilize you.

Diagnosis

Sharp pain localized to the heel may be all a doctor needs to understand in order to diagnose the presence of heel spurs. However, you may also be sent to a radiologist for X-rays to confirm the presence of heel spurs.

Non Surgical Treatment

The key for the proper treatment of heel spurs is determining what is causing the excessive stretching of the plantar fascia. When the cause is over-pronation (flat feet), an orthotic with rear foot posting and longitudinal arch support is an effective device to reduce the over-pronation, and allow the condition to heal. Other common treatments include stretching exercises, losing weight, wearing shoes that have a cushioned heel that absorbs shock, and elevating the heel with the use of a heel cradle, heel cup, or orthotic. Heel cradles and heel cups provide extra comfort and cushion to the heel, and reduce the amount of shock and shear forces experienced from everyday activities.

Surgical Treatment

Almost 90% of the people suffering from heel spur get better with nonsurgical treatments. However, if the conservative treatments do not help you and you still have pain even after 9 to 12 months, your doctor may advise surgery for treating heel spur. The surgery helps in reducing the pain and improving your mobility. Some of the surgical techniques used by doctors are release of the plantar fascia. Removal of a spur. Before the surgery, the doctor will go for some pre-surgical tests and exams. After the operation, you will need to follow some specific recommendations which may include elevation of the foot, waiting time only after which you can put weight on the foot etc.

Best Remedy For Bursitis Of The Feet

8/24/2015

Overview

Retrocalcaneal and retroachilles bursitis are both common types of bursitis that can cause pain at the back of the foot, just above the heel. This pain, and often swelling, occurs when one or both bursae at the back of the heel become irritated and inflamed. Because they have similar symptoms, heel bursitis is sometimes confused with problems affecting the Achilles tendon, which is a long strip of fibrous tissue that connects the back of the heel to the calf muscle. Other times, Achilles tendon problems may bring about the bursitis. For example, tight calf muscles can contribute to chronic pulling where the Achilles tendon inserts into the back of the heel. This pulling can result in friction and irritation that eventually lead to bursitis.

Causes

Retrocalcaneal bursitis is generally caused by local trauma from poorly designed shoes. Patients complain of posterolateral heel pain and may have a posterior heel prominence (?pump bump?), as well as local swelling and tenderness over the Achilles tendon. Pain is increased by squeezing the bursa from side to side and anterior to the Achilles. A heel lift and open-back shoes help alleviate pressure.

Symptoms

Pain at the back of the heel at the attachment site of the Achilles tendon when running. Pain on palpation of the back of the heel or bottom of heel. Pain when standing on tiptoes. Swelling and redness at the back and bottom of the heel.

Diagnosis

Your doctor will take a history to find out if you have the symptoms of retrocalcaneal bursitis. By examining your ankle, he or she can generally tell the location of the pain. The physician will look for tenderness and redness in the back of the heel. The pain may be worse when the doctor bends the ankle upward (dorsiflex), as this may tighten the achilles tendon over the inflamed bursa. Alternatively, the pain may be worse with toe rise, as this puts stress on the attachment of the achilles tendon to the heel bone. Imaging studies such as X-ray and MRI are not usually necessary at first. If initial treatment fails to improve the symptoms, these studies may be obtained. MRI may show inflammation.

Non Surgical Treatment

All types of bursitis often can be successfully managed non-surgically, and possible treatments include use of ice packs or compressive dressings, activity modification that may reduce stress or irritation, administration of nonsteroidal anti-inflammatory drugs (NSAIDs) or antibiotics, corticosteroid injections (knee and elbow), stretching exercises, and/or change of footwear (heel). Surgery may be required in patients whose symptoms remain following these treatments and in certain situations when infection is involved.

Surgical Treatment

Surgery is rarely need to treat most of these conditions. A patient with a soft tissue rheumatic syndrome may need surgery, however, if problems persist and other treatment methods do not help symptoms.

Prevention

Prevention can be accomplished by controlling your foot structure with good supportive shoes or arch supports. Pay attention to early signs of friction like blister formation. This tells you where the areas that are more likely to cause a bursa to form and subsequently a bursitis.

What Is The Treatment For Hammer Toes

6/30/2015

Overview

Hammer toes can result in pain and difficulty in moving the toe. Corns, calluses and blisters can occur from the rubbing of the contracted toe against the inside of the footwear. Both Hammer toes and mallet toe can cause pain during walking, running and other activities. If left untreated, the tendons of the toe may contract and tighten, causing the toe to become permanently stiff and contracted. A podiatric physician or surgeon may have to cut or realign tendons and/or remove pieces of bone to straighten the toe. This may require that the bones be fixed temporarily with pins while the toe heals.

Causes

Medical problems, such as stroke or diabetes that affect the nerves, may also lead to hammertoe. For example, diabetes can result in poor circulation, especially in the feet. As a result, the person may not feel that their toes are bent into unnatural positions. The likelihood of developing hammertoe increases with age and may be affected by gender (more common in women) and toe length; for example, when the second toe is longer than the big toe, hammertoe is more likely to occur. Hammertoe may also be present at birth. Genetics may factor in to developing hammertoe, particularly if the foot is flat or has a high arch, resulting in instability.

Symptoms

People with a hammer toe will often find that a corn or callus will develop on the top of the toe, where it rubs against the top of the footwear. This can be painful when pressure is applied or when anything rubs on it. The affected joint may also hammertoes be painful and appear swollen.

Diagnosis

The earlier a hammertoe is diagnosed, the better the prognosis and treatment options. Your doctor will be able to diagnose your hammertoe with a simple examination of the foot and your footwear. He or she may take an x-ray to check the severity of the condition. You may also be asked about your symptoms, your normal daily activities, and your medical and family history.

Non Surgical Treatment

Inserts in your shoes can be used to help relieve pressure on the toes from the deformity. Splints/Straps. These can be used to help re-align and stretch your toes and correct the muscle imbalance and tendon shortening. One of the most common types are toe stretchers like the yogatoe. Chiropody. A chiropodist can remove calluses or corns, areas of hard skin that have formed to make the foot more comfortable.Steroid injections can help to reduce pain and inflammation.

Surgical Treatment

If your toe is not bendable, your doctor may recommend surgery. The type of surgery that will be performed will depend on the severity of the condition. You should expect blood and urine studies before the procedure, as well as x-rays of your feet. Your doctor will inject either a local or regional anesthetic. If your toe has some flexibility, the doctor may be able to straighten it by simply making an incision in the toe to release or lengthen the tendon. If the toe is not flexible, your doctor will probably make the same incision to release the tendon, but he or she may also remove some pieces of the bone so that the bone can be straightened. A k-wire is placed in the toe to help hold it straight while it is healing. This is taken out after about four weeks.

Prevention

Although the feet naturally change over time, and abnormalities like hammertoes may be hereditary for some patients, steps may be taken to prevent their development in the first place. Just as better fitting shoes are a treatment, they are also a preventative measure for hammertoes. In addition, your podiatrist may suggest orthotics to improve the biomechanics of your feet in an effort to prevent the development of hammertoes or other abnormalities. Calf stretching and other exercises may also be used to reverse or treat muscle imbalances that could eventually lead to hammertoe development.

Can Hammer Toe Lead To Plantar Fasciitis

6/27/2015

Overview

Hammer toes is the general term used to describe an abnormal contraction or "buckling" of the toe because of a partial or complete dislocation of one of the joints of the toe or the joint where the toe joins with the rest of the foot. As the toe becomes deformed, it rubs against the shoe and the irritation causes the body to build up more and thicker skin to help protect the area. The common name for the thicker skin is a corn.

Causes

Hammer toes result from a muscle imbalance which causes the ligaments and tendons to become unnaturally tight. This results in the joint curling downward. Arthritis can also lead to many different forefoot deformities, including hammer toes.

Symptoms

At first, a hammertoe or mallet toe may maintain its flexibility and lie flat when you're not wearing crowded footwear. But eventually, the tendons of the toe may contract and tighten, causing your toe to become permanently stiff. Your shoes can rub against the raised Hammer toe portion of the toe or toes, causing painful corns or calluses.

Diagnosis

The exam may reveal a toe in which the near bone of the toe (proximal phalanx) is angled upward and the middle bone of the toe points in the opposite direction (plantar flexed). Toes may appear crooked or rotated. The involved joint may be painful when moved, or stiff. There may be areas of thickened skin (corns or calluses) on top of or between the toes, a callus may also be observed at the tip of the affected toe beneath the toenail. An attempt to passively correct the deformity will help elucidate the best treatment option as the examiner determines whether the toe is still flexible or not. It is advisable to assess palpable pulses, since their presence is associated with a good prognosis for healing after surgery. X-rays will demonstrate the contractures of the involved joints, as well as possible arthritic changes and bone enlargements (exostoses, spurs). X-rays of the involved foot are usually performed in a weight-bearing position.

Non Surgical Treatment

A person with hammer toes will be asked to practice some exercises for their toes to regain average structure and movement. The exercises usually involve stretching and strengthening their toes. The person may attempt to pick things up off the floor using only their toes. They may also stretch their toes on a regular basis by hand to ease them into straightening out. Another example of a physical exercise specifically for a person's toes involves crumpling a towel with the toes. The towel can lie underneath the person's feet and the person can use their toes to scrunch up the towel as they perform simple tasks such as reading a book or watching television.

Surgical Treatment

There are generally two methods surgeons use to correct hammer toes, they are joint resection (arthroplasty) or bone mending (fusion), and the location where this is performed on the toe depends on where the toe is buckled. Its important to recognize that most of the surgical work involved the joints of the toe, not the joint of the ball of the foot. Sometimes a toe relocation procedure is needed when the joint of the ball of the foot is malaligned (subluxed or dislocated).

Prevention

Preventing foot problems, including hammertoes, is often a matter of wearing the right shoes and taking care of your feet. Check your feet regularly for problems. This is especially true if you have diabetes or any other medical condition that causes poor circulation or numbness in your toes. If you do, check feet daily so that problems can be caught early on.

Do Bunions Ever Need Surgery Treatment?

6/19/2015

Overview
Bunions

A bunion is a foot deformity where your big toe slants outward horizontally, pushing the tip of the big toe up against your little toes, and creating a characteristic sharp angle along the inside of your foot, at what?s called the first metatarsophalangeal joint-where your big toe connects to your foot. The reason for the deformity is an abnormal growth of bone, so it is not a condition that will correct itself naturally. Though bunions, or hallux valgus, as they are known in the medical community, are well-known among the general population for causing pain and discomfort, they can have a big impact on your running as well. Women?s marathon wo

The Truth Concerning Over-Pronation Of The Foot

6/1/2015

Overview

Overpronation and underpronation describe general foot movements. These terms do not necessarily describe a medical problem with a foot. For example, you can overpronate and not have any problems or symptoms at all. It is important to have your foot structure and symptoms adequately assessed by your prescribing physician and a qualified practitioner such as a Canadian Certified Pedorthist. Once the underlying conditions and mechanical faults are assessed, an appropriate treatment plan including possible orthotic and footwear recommendations can be made.

Causes

There are many biomechanical issues that can contribute to excessive pronation, including weak foot intrinsic muscles, limited ankle dorsiflexion mobility and calf flexibility, weak ankle invertor muscles (e.g. posterior tibialis), weak forefoot evertor muscles (peroneus longus), poor hip strength and control, Anterior pelvic tilting, heel InversionIn a person who overpronates, the heel bone goes into an everted position meaning that it turns out away from the midline of the body. The opposite motion of eversion is inversion. Inversion is a motion that needs to be controlled to prevent the foot from excessively pronating.

Symptoms

If you overpronate, your symptoms may include discomfort in the arch and sole of foot, your foot may appear to turn outward at the ankle, your shoes wear down faster on the medial (inner) side of your shoes. Pain in ankle, shins, knees, or hips, especially when walking or running are classic symptoms of overpronation. Overpronation can lead to additional problems with your feet, ankles, and knees. Runners in particular find that overpronation can lead to shin splints, tarsal tunnel syndrome, plantar fasciitis, compartment syndrome, achilles tendonitis, bunions or hallux valgus, patello-femoral pain syndrome, heel spurs, metatarsalgia.

Diagnosis

If you cannot afford to get a proper gait analysis completed, having someone observe you on a treadmill from behind will give you an idea if you are an overpronator. It is possible to tell without observing directly whether you are likely to be an overpronator by looking at your foot arches. Check your foot arch height by standing in water and then on a wet floor or piece of paper which will show your footprint. If your footprints show little to no narrowing in the middle, then you have flat feet or fallen arches. This makes it highly likely that you will overpronate to some degree when running. If you have low or fallen arches, you should get your gait checked to see how much you overpronate, and whether you need to take steps to reduce the level to which you overpronate. Another good test is to have a look at the wear pattern on an old pair of trainers. Overpronators will wear out the outside of the heel and the inside of the toe more quickly than other parts of the shoe. If the wear is quite even, you are likely to have a neutral running gait. Wear primarily down the outside edge means that you are a supinator. When you replace your running shoes you may benefit from shoes for overpronation. Motion control or stability running shoes are usually the best bet to deal with overpronation. Over-Pronation

Non Surgical Treatment

The following exercises help retrain the foot and ankle complex to correct overpronation. Exercises may be performed while wearing shoes, or for an even greater challenge, in bare feet. Duck Stand. This exercise is designed to prepare for the more dynamic BT exercises ahead by waking up the gluteal muscles and teaching clients how the gluteal muscles control the degree of foot pronation. For example, when the glutes contract concentrically, they rotate the leg outward. As the leg rotates outward, the arch of the foot raises (i.e., supinates). Stand beside the BT with both heels together and feet turned outward. (Note: As you progress, perform this exercise while standing on the BT.) Try to rotate legs outward by tightening buttock muscles while tilting pelvis under. As legs rotate outward, arches of the feet raise up out of pronation. Hold position for 30 seconds. Big Toe Pushdowns. This exercise is designed to strengthen the muscle of the big toe that holds up the arch of the foot (i.e., flexor hallucis longus muscle). This stops the foot from overpronating. Stand on top of the BT dome with feet facing forward. Use gluteal muscles to raise the arches of the feet (see previous exercise - "Duck Stand"). Keep arches raised while pushing down big toe into the BT. While pushing down, tension build in the arch on the underside of their foot should be felt. Hold position for 15 seconds.

Prevention

Massage and stretch the calves to increase dorsiflexion at the foot/ankle. Dorsiflexion is the bending at the ankle. By improving the dorsiflexion, one will have more flexibility at the ankle, which will allow the foot to over-pronate less. Massage the IT Band with a foam roller or tennis ball to quiet down the tightness throughout this part of the leg. The IT Band attaches from the glute maximus and runs down the side of the leg into the knee area. When the IT Band is tight it will accelerate the force of the leg moving inward, which will cause the foot to move inward as well. It is often that tightness through the IT Band that promotes over-pronation. Decreasing over-pronation, which is very prominent in runners, will help add endurance, speed and efficiency to your run and ultimately place less stress on your body.

Living With Severs Disease

5/16/2015

Overview

Severs disease is by far the most common cause of heel pain in young children, the condition commonly occurs in kids around the age of 10-15 years. Severs is a traction apophysitis in which inflammation of the calcaneal apophysis (growth plate) occurs as a result of overuse or micro trauma. As mentioned severs disease is caused by micro trauma and over use, this can include excessive foot pronation (foot rolling in), tight calf muscles, increase in sporting activities and inappropriate footwear. These all put extra sheering forces on the growth plate leading to aggravation and resultant pain. Signs and symptoms of this include pain on squeezing of the heel, absence of swelling and redness, child describing pain as a dull ache, limping and pain with increased activity.

Causes

This condition most commonly occurs due to repetitive or prolonged activities placing strain on the heel's growth plate, typically during a period of rapid growth. These activities (or sports) usually involve excessive walking, running, jumping or hopping. Severs disease may also be more likely to occur following a poorly rehabilitated sprained ankle, in patients with poor foot biomechanics or those who use inappropriate footwear. In young athletes, this condition is commonly seen in running and jumping sports, such as football, basketball, netball and athletics.

Symptoms

The symptoms include pain, tenderness, swelling or redness in the heel, and they might have difficulty walking or putting pressure on the heel. If you notice that your child suddenly starts walking around on their toes because their heels hurt, that?s a dead giveaway. Kids who play sports might also complain of foot pain after a game or practice. As they grow, the muscles and tendons will catch up and eventually the pressure will subside along with the pain. But in the meantime, it can become very uncomfortable.

Diagnosis

Radiography. Most of the time radiographs are not helpful because the calcaneal apophysis is frequently fragmented and dense in normal children. But they can be used to exclude other traumas. Ultrasonography. could show the fragmentation of secondary nucleus of ossification of the calcaneus in severs?s disease. This is a safe diagnostic tool since there is no radiation. This diagnostic tool can also be used to exclude Achilles tendinitis and/or retrocalcaneal bursitis.

Non Surgical Treatment

Physiotherapy treatment to improve range of the ankle and descrease soft tissue tightness. Orthotics to control excessive motion of the foot. Icing the painful area. Use of topical anti-inflammatory cream. Taping of the foot during exercise. Stretching, only if recommended by the physiotherapist.

Recovery

The condition is normally self-limiting, and a return to normal activities is usually possible after a period of 2-3 months. In one study, all the patients treated with a physiotherapy programme (above) improved and could return to their sport of choice after two months of treatment. The condition may recur, although recurrence was uncommon, according to one study.

Leg Length Discrepancy And Running Performance

4/27/2015

Overview

Leg length discrepancy (LLD) affects about 70% of the general population, and can be either structural - when the difference occurs in bone structures - or functional, because of mechanical changes at the lower limbs. The discrepancy can be also classified by its magnitude into mild, intermediate, or severe. Mild LLD has been particularly associated with stress fracture, low back pain and osteoarthritis, and when the discrepancy occurs in subjects whose mechanical loads are increased by their professional, daily or recreational activities, these orthopaedic changes may appear early and severely. The aim of this study was to analyze and compare ground reaction force (GRF) during gait in runners with and without mild LLD. Results showed that subjects with mild LLD of 0.5 to 2.0 cm presented higher values of minimum vertical GRF (0.57 ? 0.07 BW) at the shorter limb compared to the longer limb (0.56 ? 0.08 BW) Therefore, subjects with mild LLD adopt compensatory mechanisms that cause additional overloads to the musculoskeletal system in order to promote a symmetrical gait pattern as showed by the values of absolute symmetric index of vertical and horizontal GRF variables. Leg Length Discrepancy

Causes

LLDs are very common. Sometimes the cause isn?t known. But the known causes of LLD in children include, injury or infection that slows growth of one leg bone. Injury to the growth plate (a soft part of a long bone that allows the bone to grow). Growth plate injury can slow bone growth in that leg. Fracture to a leg bone that causes overgrowth of the bone as it heals. A congenital (present at birth) problem (one whole side of the child?s body may be larger than the other side). Conditions that affect muscles and nerves, such as polio.

Symptoms

In addition to the distinctive walk of a person with leg length discrepancy, over time, other deformities may be noted, which help compensate for the condition. Toe walking on the short side to decrease the swaying during gait. The foot will supinate (high arch) on the shorter side. The foot will pronate (flattening of the arch) on the longer side. Excessive pronation leads to hypermobility and instability, resulting in metatarsus primus varus and associated unilateral juvenile hallux valgus (bunion) deformity.

Diagnosis

There are several orthopedic tests that are used, but they are rudimentary and have some degree of error. Even using a tape measure with specific anatomic landmarks has its errors. Most leg length differences can be seen with a well trained eye, but I always recommend what is called a scanagram, or a x-ray bone length study (see picture above). This test will give a precise measurement in millimeters of the length difference.

Non Surgical Treatment

The most common solution to rectify the difference in your leg lengths is to compensate for the short fall in your shortest leg, thereby making both of your legs structurally the same length. Surgery is a drastic option and extremely rare, mainly because the results are not guaranteed aswell as the risks associated with surgery, not to mention the inconvenience of waiting until your broken bones are healed. Instead, orthopediatrician's will almost always advise on the use of "heel lifts for leg length discrepancy". These are a quick, simple and costs effective solution. They sit under your heel, inside your shoe and elevate your shorter leg by the same amount as the discrepancy. Most heel lifts are adjustable and come in a range of sizes. Such lifts can instantly correct a leg length discrepancy and prevent the cause of associate risks.

Surgical Treatment

Differences of an inch-and-a-half to two inches may require epiphysiodesis (adjusting the growth of the longer side) or acute shortening of the other side. Differences greater than 2.5 inches usually require a lengthening procedure. The short bone is cut and an external device is applied. Gradual lengthening is done over months to allow the muscles and nerves accommodate the new length.

Which Are The Key Causes Of Adult Aquired Flat Feet ?

4/25/2015

Overview
The posterior tibial tendon serves as one of the major supporting structures of the foot, helping it to function while walking. Posterior tibial tendon dysfunction (PTTD) is a condition caused by changes in the tendon, impairing its ability to support the arch. This results in flattening of the foot. PTTD is often called ?adult acquired flatfoot? because it is the most common type of flatfoot developed during adulthood. Although this condition typically occurs in only one foot, some people may develop it in both feet. PTTD is usually progressive, which means it will keep getting worse, especially if it isn?t treated early. Adult Acquired Flat Feet

Causes
As discussed above, many health conditions can create a painful flatfoot. Damage to the posterior tibial tendon is the most common cause of AAFD. The posterior tibial tendon is one of the most important tendons of the leg. It starts at a muscle in the calf, travels down the inside of the lower leg and attaches to the bones on the inside of the foot. The main function of this tendon is to hold up the arch and support your foot when you walk. If the tendon becomes inflamed or torn, the arch will slowly collapse. Women and people over 40 are more likely to develop problems with the posterior tibial tendon. Other risk factors include obesity, diabetes, and hypertension. Having flat feet since childhood increases the risk of developing a tear in the posterior tibial tendon. In addition, people who are involved in high impact sports, such as basketball, tennis, or soccer, may have tears of the tendon from repetitive use. Inflammatory arthritis, such as rheumatoid arthritis, can cause a painful flatfoot. This type of arthritis attacks not only the cartilage in the joints, but also the ligaments that support the foot. Inflammatory arthritis not only causes pain, but also causes the foot to change shape and become flat. The arthritis can affect the back of the foot or the middle of foot, both of which can result in a fallen arch.

Symptoms
Not everyone with adult flatfoot has problems with pain. Those who do usually experience it around the ankle or in the heel. The pain is usually worse with activity, like walking or standing for extended periods. Sometimes, if the condition develops from arthritis in the foot, bony spurs along the top and side of the foot develop and make wearing shoes more painful. Diabetic patients need to watch for swelling or large lumps in the feet, as they may not notice any pain. They are also at higher risk for developing significant deformities from their flatfoot.

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
PTTD is a progressive condition. Early treatment is needed to prevent relentless progression to a more advanced disease which can lead to more problems for that affected foot. In general, the treatments include rest. Reducing or even stopping activities that worsen the pain is the initial step. Switching to low-impact exercise such as cycling, elliptical trainers, or swimming is helpful. These activities do not put a large impact load on the foot. Ice. Apply cold packs on the most painful area of the posterior tibial tendon frequently to keep down the swelling. Placing ice over the tendon immediately after completing an exercise helps to decrease the inflammation around the tendon. Nonsteroidal Anti-inflammatory Medication (NSAIDS). Drugs, such as arcoxia, voltaren and celebrex help to reduce pain and inflammation. Taking such medications prior to an exercise activity helps to limit inflammation around the tendon. However, long term use of these drugs can be harmful to you with side effects including peptic ulcer disease and renal impairment or failure. Casting. A short leg cast or walking boot may be used for 6 to 8 weeks in the acutely painful foot. This allows the tendon to rest and the swelling to go down. However, a cast causes the other muscles of the leg to atrophy (decrease in strength) and thus is only used if no other conservative treatment works. Most people can be helped with orthotics and braces. An orthotic is a shoe insert. It is the most common non-surgical treatment for a flatfoot and it is very safe to use. A custom orthotic is required in patients who have moderate to severe changes in the shape of the foot. Physiotherapy helps to strengthen the injured tendon and it can help patients with mild to moderate disease of the posterior tibial tendon. Acquired Flat Foot

Surgical Treatment
For more chronic flatfoot pain, surgical intervention may be the best option. Barring other serious medical ailments, surgery is a good alternative for patients with a serious problem. There are two surgical options depending on a person?s physical condition, age and lifestyle. The first type of surgery involves repair of the PTT by transferring of a nearby tendon to help re-establish an arch and straighten out the foot. After this surgery, patients wear a non-weight bearing support boot for four to six weeks. The other surgery involves fusing of two or three bones in the hind foot below the ankle. While providing significant pain relief, this option does take away some hind foot side-to-side motion. Following surgery, patients are in a cast for three months. Surgery is an effective treatment to address adult-acquired flatfoot, but it can sometimes be avoided if foot issues are resolved early. That is why it is so important to seek help right away if you are feeling ankle pain. But perhaps the best way to keep from becoming flatfooted is to avoid the risk factors altogether. This means keeping your blood pressure, weight and diabetes in check.