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Monday, October 3, 2011

A Family Doctor's Tale - FLAT FOOT

DOC I HAVE FLAT FOOT

Flat Foot is a common disorder of the foot characterized by the depression or loss of the medial longitudinal arch of the foot.

It is usually associated with valgus of the foot or eversion of the heel and abduction of the forefoot.

It is also associated with a tight Achilles tendon.
 
The cause of Flat Foot is :
1.hereditary and associated with hypermobilty of the other joints

2.a rupture of the posterior tibial tendon

Symptoms:
1.Pain in the foot especially when standing for a prolonged period

2.easy fatigabilty of the foot.
 
3.Certain weight bearing exercises like jogging or brisk walking makes the pain worse

Signs:

1.absence of the medial arch is present

2.hypermobility of the foot is apparent

3.mild genu valgum (knock knee) or internal tibial torsion is also present.

4.Xrays of the foot usually show a loss of the normal arch and plantar flexion of the talus.

Complications:
1.mild deformity of the foot

2.strain on the back (lumbar spine) with prolonged standing

3.heel cord contractures

Conservative treatment:
1.no treatment is usually necessary if mild

2.shoe correction may help temporarily

3.Exercises to stretch and loosen tigh heel cords

4.Pain killers such as NSAID(non-steroidal anti-inflammatory drugs) for pain

5.Muscle relaxant to relax muscles especially the back

Surgery:

Surgery is usually not indicated in Flat Foot.
Rarely surgery is to tighten the muscles supporting the medial arch of the foot only for severe cases with symptoms of pain and to prevent complcations.

Prognosis:
There is no cure for flat foot but surgery may help in severe cases to prevent complcations.

Prevention:
avoid prolonged standing

use shoes with medial arch correction pads

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