The progressing deteriorating of a flat foot or dropped arch of the foot in an adult is usually called posterior tibial tendon dysfunction or adult acquired flatfoot that can have problematic outcomes if not identified earlier and sorted out. This is often more frequent in older in addition to obese adults. The main problem is how the posterior tibial muscles that are the reason for holding up the arch of the foot is no longer effective at doing this, so a gradual flattening of the foot happens. As well as a falling of the arch of the feet there is usually increasing discomfort and pain in the arch of the feet and the rearfoot. As the posterior tibial tendon dysfunction moves along, further walking gets progressively harder and it is quite fatiguing.
There are actually generally four stages of posterior tibial tendon dysfunction that this problem continues through with one being the initial phase and 4 being the final phase that only surgical treatment can deal with. There is certainly some difference of opinion with the staging with this as their is variability amongst health professionals and some reliability concerns. While acknowledging that, stage 1 is typically handled with foot orthotics along with exercises plus some relief for the pain and discomfort. Stage 2 generally requires much more aggressive and supportive foot supports, carrying on with the exercises and higher amounts of pain relief medicines may be needed. Both stages 1 and 2 may benefit with high top supporting shoes. Long-term weight loss plans can also be going to be beneficial. When this does not prevent the development and the foot is proceeding towards a stage three, then there is increasing possibility that reconstructive foot surgical treatment is probably going to be necessary. This is why it is so critical that there be more aggressive conservative management of the feet when it is still in stage 2 to prevent the progress.
An extremely common strategy for posterior tibial tendon dysfunction given it moves along to stage 2 would be the Richie Brace. The brace has been commonly used and it has been shown to be very effective at halting the progression of this disorder and steering clear of the need for surgery. Surgical treatments are often effective, however, there is often a left over level of disability left over since the surgery usually may require the fusing of some important joints and the moving of muscles attachments with other areas of the foot. The Richie brace is a combination of an aggressively supportive tailor made foot orthotic with an ankle foot orthoses with struts to aid either side of the joints at the ankle. The tailor made foot orthotic is manufactured off a plaster cast or optical scan of the feet with the feet held in a corrected alignment. The objective of the foot orthoses part of the Richie Brace is to try and hold the foot in this corrected alignment. The struts which get added up the side of the ankle joint are articulated at the ankle joint to allow for movement to occur at the ankle joint. These struts will be held on by Velcro on the lower leg to help support and enhance the effects of the foot orthotic. If the progression of the condition is usually ended making use of this, then surgical procedures are commonly not needed.