What is Adult Acquired Flat Foot (AAFF)?
This condition has many different names and is different from people who grow up with flat feet. Other names for the condition include, tibialis posterior insufficiency or progressive collapsing foot deformity (PCFD). AAFF is a complex deformity in which an important tendon (tibialis posterior) degenerates, and can not provide stability for the arch of the foot, which progressively flattens.
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Causes
The tibialis posterior is a big tendon on the inside of the foot. One of the other important structures is the spring ligament, which helps to supports the arch of the foot. Both can be injured suddenly in an accident or can slowly stretch out over time. The foot changes shape, as the structures on the inside of the foot stretch out and the foot becomes flatter.
Risk Factors
- Previous injury
- Genetics
- Repetitive use of the foot and ankle
- Female
- >40 years old
- Increased weight
- Diabetes
- Rheumatoid arthritis
Symptoms
- Pain on the inside of the foot and ankle
- Pain in the inside of the arch
- Pain and weakness with activity
- Increasing deformity of foot, with loss of the arch and the foot turning outwards
- Increasing pain on the outside of the foot due to the change of shape of the foot
Diagnosis
Dr Graff will examine your foot and ankle to assess the tendons and joints in the foot. Xrays are usually taken of both feet while you are standing. An MRI scan can be useful to assess the tendons and ligaments in the foot. Sometimes weight bearing CT scans, can help with planning the surgery.
Management
Treatment is aimed at managing the pain and preventing or slowing deformity. Management options include:
- Medications: regular paracetamol and ibuprofen with foot can help with pain
- Resting from aggravating activities: Impact activities worsen the symptoms and progression of the deformity and pain
- Weight loss: the more weight that is put through foot, the worse the pain and progression can be.
- Orthotics and bracing: A brace or orthotic (either from the chemist, orthotist or podiatrist) can help support the foot and ankle to help with pain. Supportive lace up boots can also help with pain and support the foot and ankle in the earlier stages
- Physiotherapy: strengthening and stretching can help with more mild stages of the disease
- Injections: Ultrasound guided injections can be diagnostic i.e. help determine where the pain is, and also can help treat the pain and inflammation
- Surgery: There is a variety of surgeries that can help, depending on what the underlying cause and problem is.
Surgery would be tailored to the stage of AAFF and the symptoms. If you would like an opinion on this condition, please book an appointment with Dr Christy Graff here.
Useful Websites
Health Direct
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