WHERE DOES IT HURT ?
WHAT YOU NEED TO KNOW ABOUT A BENT OR PRONATED FOOT
A pronated foot or genetically acquired ‘flat foot’ is a complex deformity revealed and symptomatic when the patient is weight bearing. This 3 plane motion (dorsiflexion, eversion, and abduction) and collapsing of the inside archway can cause tendon pathology (Posterior Tendon Dysfunction), Plantir fasciitis, and stress to other structures like the ankle, knee, and hip.
Symptoms include pain, fatigue, and instability – over time and untreated, severe arthritis will develop as well as permanent tendon damage.
A shoe with a firm supportive sole is the foundation to the overall conservative treatment of the symptoms and biomechanical problems.
Soft padding in the arch may provide limited symptomatic relief but is not very effective in correcting the biomechanical problem.
Temporary arch supports or molded orthotics will give pressure relief and is the easiest solution for long term treatment with or without surgical intervention.
Anti-inflammatory medication can help with the chronic pain, but are not much help with the acute pain.
Foot and ankle orthoses or bracing can hold the foot in a better position to relieve the stress on the Posterior Tibialis tendon and the most stable supportive solution with or without surgery.
The type of surgical correction needed depends mostly on how long the problem has been present. Surgery can be as simple as cleaning the inflamed tube around the tendon if the tendon is healthy or as complex as removing the part of the tendon that is completely damaged and stretched out and reconnecting the remaining healthy tendon to the nearby bone. Other procedures to the nearby bones may need to be done during surgery in order to get the best outcome. The incision can vary in size (4cm – 6 cm) and number of incisions depending on the complexity.
The procedure is performed in an outpatient facility under sedation and non weight bearing is essential for 3 to 6 weeks after 48 to 72 hours bed rest and foot elevation. Partial weight bearing can begin at 6 to 8 weeks in a walking cast.
The procedures are performed at an out-patient facility under sedation or general anesthesia. This is a complex surgery with possible joint fusions, bone grafting and internal fixation devices. Depending upon the complexity of the foot problem(s), there could be additional or 'staged' surgeries. Post operative restrictions range from 6-8 weeks of non-weight bearing to insure proper healing.
These are links to more information on the subject, not intended to imply an endorsement.
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Our doctors have extended specialist medical training focused on the foot, ankle and lower leg. We are board-certified surgeons and experts in delivering care for complex foot and ankle disorders as well as cosmetic or reconstructive procedures and problems related to sports injuries and other medical conditions.
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