Avoid Adult-Acquired Flatfoot

A client of mine has adult-acquired flat foot and presented with significant pain along the outside of the ankle and foot region when walking. She had been to see a surgeon who had suggested surgery but she was keen to see if there was anything Physiotherapy could do to assist with the view to possibly avoiding having to go down the surgical route.

As mentioned in the article linked at the bottom, the tibialis posterior tendon was deficient and therefore not able to adequately support my clients foot arch - resulting in a significant ‘rolling in’ effect which places additional mechanical strain on other parts of the foot.

Help of a shoe insole / orthotic

Because the injury to the tendon was not new, it was not necessary to offload this tendon using a boot. As such we were able to move straight onto prescribing a customised orthotic device which sits in the shoe and helps support the arch in place of the deficient tendon.

Before supplying the orthotic, we were confident that it would help as there was a good response to a supportive taping technique which mimics the effect of an orthotic and is a low cost measure to determine if an orthotic will be helpful or not. Further information about our orthotic service here.

While waiting for the orthotic to arrive, mobilisation techniques and electroacupuncture were used to help settle a painful 5th metatarso-phalangeal joint (small joint linking the outer long bone of the foot)

When the orthotic arrived, it slipped comfortably into the shoe and has resulted in a significant reduction in pain while walking allowing for overall better mobility and independence. We are going to trial the use of the orthotic over the coming months and hopefully this will remove the need for surgery.

Referenced article

Pay-attention-to-pain-avoid-adult-acquired-flatfoot

By Simon Coghlan MSc, BSc Hons, DipMedAc, MISCP
Simon holds a Master of Science Degree in Physiotherapy and is a member of the Irish Society of Chartered Physiotherapists. A post graduate Diploma in Medical Acupuncture entitles him to accredited membership of the British Medical Acupuncture Society. Simon specialises in the integration of medical acupuncture techniques with manual therapy and therapeutic exercise for the treatment of musculo-skeletal pain and dysfunction.