No, Not All “Flat Feet” Are Bad—but This One Deserves Attention

19 Nov No, Not All “Flat Feet” Are Bad—but This One Deserves Attention

No, Not All “Flat Feet” Are Bad—but This One Deserves Attention –
Adult Acquired Flatfoot Deformity: Why Early Treatment Matters

No, Not All “Flat Feet” Are Bad—but This One Deserves Attention
Not all flat feet are cause for concern, but Adult Acquired Flatfoot Deformity (AAFD) is one you don’t want to ignore. AAFD is a progressive flattening of the foot arch that worsens over time, potentially leading to significant discomfort and mobility issues. The good news? With early intervention and the right treatment, we can not only make you more comfortable but also prevent this condition from progressing further.

Understanding Adult Acquired Flatfoot Deformity (AAFD)
Adult Acquired Flatfoot Deformity (AAFD) is characterised by the gradual collapse of the arch in one or both feet, often resulting in discomfort, difficulty walking, and a range of biomechanical issues. Also known as “fallen arches” or “posterior tibial tendon dysfunction (PTTD),” AAFD can develop over time, impacting everyday movement and quality of life.

This educational article aims to provide insights into the causes, stages, and treatment options for AAFD, using the latest research and clinical knowledge to support a comprehensive approach to care. Whether you’re noticing changes in your foot structure or dealing with discomfort, understanding the best treatment options available is a valuable step towards finding relief and regaining stability.

What Causes Adult Acquired Flatfoot Deformity?
Several factors can contribute to the development of AAFD, including age-related changes, injury, obesity, and inflammatory conditions. The primary driver of this deformity is often dysfunction of the posterior tibial tendon, which plays a crucial role in supporting the arch of the foot. Over time, if this tendon weakens or becomes damaged, the arch may begin to collapse, causing the foot to roll inward.

Stages of AAFD
AAFD progresses in stages, each with varying degrees of severity and symptoms:

• Stage I: Mild pain, with the posterior tibial tendon showing inflammation but still functioning.
• Stage II: Noticeable flattening of the arch, pain, and reduced mobility, though the deformity is still flexible.
• Stage III: Fixed deformity with significant pain and limited mobility. Non-surgical treatments may be less effective at this stage.
• Stage IV: Severe, often involving arthritis in the ankle and other foot joints, and requires more advanced interventions.

Recognising the stage of AAFD can help guide the treatment plan and select the most appropriate therapies for each individual.

Treatment Options for Adult Acquired Flatfoot Deformity
Effective treatment for AAFD requires a combination of approaches tailored to the stage and specific symptoms of the deformity. Here are some evidence-based treatment options that may be recommended:

1. Richie Brace
   For individuals in the earlier stages of AAFD, the Richie Brace is a functional ankle-foot orthosis designed to support the arch and stabilise the ankle. Studies indicate that using the Richie Brace for 12 to 18 months can significantly improve stability, pain levels, and overall function in people with AAFD. After this period, transitioning to a custom orthotic may be beneficial to maintain support long-term.
2. Strengthening Exercises
   Exercise plays a critical role in managing AAFD by targeting key muscle groups that support the arch. Strengthening exercises, particularly for the posterior tibial tendon and surrounding muscles, can enhance stability and reduce strain on the foot. Research emphasises the importance of progressive loading exercises that build tissue capacity over time.
   • Example Exercises: Calf raises, resisted ankle inversion, and balance exercises are common techniques to strengthen the foot and ankle.
3. Photobiomodulation Therapy (PBMT)
   Photobiomodulation therapy, also known as high power laser therapy, uses specific wavelengths of light to reduce inflammation and promote tissue healing. PBMT has shown promising results in managing pain and enhancing tissue repair in foot-related conditions. For those with symptomatic AAFD, PBMT can be a useful addition to traditional therapies.
4. Radial Pressure Wave Therapy (Shockwave Therapy)
   Shockwave therapy, or radial pressure wave therapy, is a non-invasive treatment that stimulates healing to affected tissues. Studies show that shockwave therapy can be effective in reducing pain and improving function in patients with tendon-related injuries, such as those seen in AAFD. This therapy is particularly useful for individuals experiencing chronic pain.
5. Taping Techniques
   Taping provides temporary support to the foot and can help alleviate discomfort during daily activities. Techniques such can offload stress on the posterior tibial tendon, reduce strain on the arch, and improve alignment. While not a long-term solution, taping is a helpful tool in managing symptoms during exercise or prolonged periods of standing.
6. Appropriate Footwear
   Choosing the right footwear is essential for managing AAFD, as supportive shoes can reduce strain on the arch and limit excessive inward rolling of the foot. Footwear with good arch support, a firm heel counter, and a slightly elevated heel can enhance comfort and stability. Avoiding unsupportive footwear, such as flip-flops or overly flexible shoes, is advised.
7. Orthotics
   Custom orthotics provide long-term support to individuals with AAFD by addressing specific biomechanical needs. For those transitioning from the Richie Brace or requiring extra stability, orthotics can help redistribute pressure, reduce strain on the posterior tibial tendon, and maintain proper alignment. Research supports the use of orthotics as a preventive measure against further progression of AAFD.

The Foot Studio’s Expertise in Treating AAFD
At The Foot Studio, we’re committed to providing personalised, evidence-based care for conditions like Adult Acquired Flatfoot Deformity. Our approach combines the latest therapeutic techniques with tailored solutions that prioritise long-term function and mobility. Whether through the Richie Brace, advanced therapies like PBMT and shockwave therapy, or customised orthotics, our team works with you to ensure you receive the highest level of care.

Ready to Take the Next Step?
If you’re dealing with AAFD or experiencing foot pain, reach out to our team to learn more about these treatment options and how we can help.

Let’s work together to keep you moving with confidence and comfort!

Laura 🌿