Surgery for flat feet is somewhat like the a la carte menu at a restaurant in the sense that there are several smaller operations that can be put together with each smaller one meant to address one aspect of the problem. If this treatment combination does not work well enough to improve the pain, then surgery can be considered. Physical therapy can be used as well to try to both strengthen the posterior tibial tendon and muscle, while also stretching out the calf muscle which is the primary force that works against the tendon this treatment is often, although not always, successful. An orthotic (arch support) is often used in an effort to take advantage of the fact that many flat feet tend to be flexible, and so the orthotic will typically push the arch up so that the posterior tibial tendon does not have to work as hard to do its job. The initial treatment for this problem typically involves attempting to create a healthier mechanical environment for this tendon. How are flat feet, or collapsed arches treated? A deficient tibial tendon will lead to arch collapse over time. The “wearing out” of this tendon often causes some degeneration that can be difficult to heal. In some people, for reasons that are not always clear, the tendon can wear out over time, or it can be injured. In order to do this, it must pull up slightly on the arch so that the foot is placed in a more rigid position. The posterior tibial tendon is a tendon that runs on the inside of the ankle it helps to put your foot in the right position so that the Achilles tendon can effectively power your gait forward. The posterior tibial tendon attaches the calf muscle to the bones on the inside of the foot.
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