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Pes Planus Explained

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Flat Foot

Flat feet, fallen arches, or ?pes planus? is normally a symptomless and fortunately painless condition. It is characterized by the arch of the foot collapsing completely, which causes the entire sole of the foot to come into perfect contact with the ground. An estimated 20-30 percent of the entire population has some form of flat feet, ranging in severity from asymptomatic to somewhat problematic. Most people who endure this problem are able to experience life pain and symptom free from the nearly unnoticeable abnormality. However, a small sector of those affected do experience pain or discomfort, which is when a treatment program needs to be put in action.

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

Not everyone who has flat feet experiences symptoms. Others, however, feel persistent pain in their feet and wearing shoes can prove additionally painful. Others only feel symptoms when they walk more than normal, go jogging or participate in a sport that involves running or kicking.

Diagnosis

Your doctor examines your feet to determine two things, whether you have flat feet and the cause or causes. An exam may include the following steps, Checking your health history for evidence of illnesses or injuries that could be linked to flat feet or fallen arches, Looking at the soles of your shoes for unusual wear patterns, Observing the feet and legs as you stand and do simple movements, such as raising up on your toes, Testing the strength of muscles and tendons, including other tendons in the feet and legs, such as the Achilles tendon or the posterior tibial tendon, Taking X-rays or an MRI of your feet.

flat feet exercises

Non Surgical Treatment

Treatment in adults generally consists of wearing spacious, comfortable shoes with good arch support. Your doctor may recommend padding for the heel (heel cup) or orthotic shoe devices, which are molded pieces of rubber, leather, metal, plastic, or other synthetic material that are inserted into a shoe. They balance the foot in a neutral position and cushion the foot from excessive pounding. For children, treatment using corrective shoes or inserts is rarely needed, as the arch usually develops normally by age 5.

Surgery is rarely needed.

Surgical Treatment

Acquired Flat Foot

Surgery is typically offered as a last resort in people with significant pain that is resistant to other therapies. The treatment of a rigid flatfoot depends on its cause. Congenital vertical talus. Your doctor may suggest a trial of serial casting. The foot is placed in a cast and the cast is changed frequently to reposition the foot gradually. However, this generally has a low success rate. Most people ultimately need surgery to correct the problem. Tarsal coalition. Treatment depends on your age, extent of bone fusion and severity of symptoms. For milder cases, your doctor may recommend nonsurgical treatment with shoe inserts, wrapping of the foot with supportive straps or temporarily immobilizing the foot in a cast. For more severe cases, surgery is necessary to relieve pain and improve the flexibility of the foot. Lateral subtalar dislocation. The goal is to move the dislocated bone back into place as soon as possible. If there is no open wound, the doctor may push the bone back into proper alignment without making an incision. Anesthesia is usually given before this treatment. Once this is accomplished, a short leg cast must be worn for about four weeks to help stabilize the joint permanently. About 15% to 20% of people with lateral subtalar dislocation must be treated with surgery to reposition the dislocated bone.

Prevention

oll away pain. If you're feeling pain in the arch area, you can get some relief by massaging the bottom of your foot. A regular massage while you're watching TV can do wonders" Stretch out. Doing the same type of stretching exercises that runners do in their warm-up can help reduce arch pain caused by a tight heel cord. One of the best exercises is to stand about three feet from a wall and place your hands on the wall. Leaning toward the wall, bring one foot forward and bend the knee so that the calf muscles of the other leg stretch. Then switch legs. Stretching is particularly important for women who spend all week in heels and then wear exercise shoes or sneakers on weekends. Get measured each time you buy new shoes. Don't assume that since you always wore a particular size, you always will. Too many people try to squeeze into their 'regular' shoe size and wind up with serious foot problems or sores on their feet. When your arch is falling, your feet may get longer or wider and you may or may not feel pain, so getting your foot measured each time you buy shoes is a good indicator of your arch's degeneration. Examine your shoes. If the heel is worn down, replace it. But if the back portion of the shoe is distorted or bent to one side, get yourself into a new pair of supportive shoes like those made specifically for walking. That's because flat feet can affect your walking stride, and failing to replace worn shoes may lead to knee or hip pain.

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