The foot surgeons of Slocum Center are trained and experienced in treating progressive flatfoot. We have been providing care for foot injuries and conditions for decades. That means your treatment will be provided by a team whose experience is virtually unmatched in Eugene and throughout the Northwest.
One of the more important tendons responsible for maintaining appropriate alignment of the foot is the posterior tibial tendon. The posterior tibial tendon helps support the arch. If the tendon becomes inflamed or stretched, there may be gradual loss of height of the arch. There may also be turning out of the heel and turning out of the forefoot. Patients frequently complain of pain along the inner side of the ankle. However, as the deformity progresses, pain over the outer side of the ankle may also develop.
This deformity is usually gradual in onset; although, occasionally the tendon will tear acutely, resulting in a rapid progression of the deformity.
Risk factors include obesity, hypertension, diabetes, and systemic inflammatory diseases such as rheumatoid arthritis.
Early treatment consists of nonsteroidal anti-inflammatory medications, arch support (orthoses), and a physical therapy program emphasizing range of motion, strengthening, and balance exercises. If the tendon shows swelling and acute tenderness, a walking cast may be recommended. The cast immobilization and/or boot immobilization is for 3-6 weeks. Many times, the immobilization, physical therapy and orthoses will resolve the pain. If nonoperative treatments do not work, surgery is an option.
Surgery may consist of the following:
- Removing the inflamed tissue from around the tendon to decrease pain and decrease the chance of future rupture.
- The heel bone may be surgically broken and realigned.
- There may be a need to transfer another tendon to support the damaged posterior tibial tendon.
- Lengthening of the outside column of the foot. In this procedure, a small wedge of bone is removed from the hip and placed into the outside of the heel bone, which helps realign the foot.
- Fusing of the bones in the midfoot, limiting the deformity.
All of the above procedures require extensive rehabilitation. If surgery is performed, rehabilitation can take 6-9 months.