The gradual worsening of a flat foot or dropped arch of the foot in an adult is oftentimes labeled posterior tibial tendon dysfunction or adult acquired flatfoot that can have major consequences if not observed earlier and dealt with. This is often more common in older in addition to overweight adults. The key problem is that the posterior tibial muscles which are given the task of holding up the arch of the feet are no longer very good at doing this, and so a ongoing flattening of the feet happens. As well as a collapsing with the arch of the foot there may be generally increasing pain and discomfort in the arch of the foot and also the rearfoot. As the posterior tibial tendon dysfunction continues, further walking gets increasingly tougher and it is very fatiguing.
There are actually generally four phases connected with posterior tibial tendon dysfunction how the problem advances through with one being the early stage and four being the end phase that only surgical treatment can fix. There is some disagreement of the staging with this as their is variability between health professionals plus some reliability issues. Having said that, stage one is typically managed with foot orthotics as well as exercises and some drugs for the pain. Stage 2 usually needs much more aggressive and supporting foot orthoses, continuing with the exercises and increasing amounts of pain relief medicines may be needed. Both stage 1 and 2 will benefit with high top supportive shoes. Long term weight loss programs will also be going to be helpful. If this does not halt the progression and the feet are heading towards a stage 3, then there is increasing possibility that reconstructive foot surgery is probably going to be needed. For this reason it's so critical that there be more aggressive conservative treatment of the feet when it's still in stage 2 to stop the progression.
An increasingly frequent intervention for adult acquired flat foot while it progresses to stage 2 is the Richie Brace. This brace has been commonly used and it has been demonstrated to be very successful at halting the development with this condition and staying away from the requirement for surgical treatment. Surgical treatments are frequently effective, however, there is frequently a left over measure of disability left over since the surgical treatment commonly may need the fusing of some joints and the moving of muscles insertions with other parts of the foot. The Richie brace is a combination of an aggressively made tailor made foot orthoses plus an ankle foot orthotic with struts to aid either side of the ankle joint. The customized foot orthotic is crafted off a plaster cast or optical scan of the foot with the foot held in a fixed position. The aim of the foot orthotic portion of the Richie Brace would be to make an effort to hold the foot in that corrected position. The struts that get included up the outside of the ankle joint are articulated with the ankle joint allowing movement to occur at the joint. These struts are then held on by Velcro on the leg to help support and enhance the impact of the foot orthotic. If the advancement of the problem can be stopped using this, then surgical procedures are typically avoided.