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Prolotherapy:
A Great Alternative Treatment for Flat Foot Pain and Posterior
Tibial Tendon Injuries
Ross A. Hauser, M.D.
There are many causes
of flat feet. Two of the more common are genetic - you were born
with it. Acquired flat footedness, on the other hand, usually
means your posterior tibial tendon is worn out and not
supporting your arch. Often, but not always, a flat foot can be
painful and achy. Usually, but not always, posterior tibial
tendon injuries, can be painful. Very painful!
The posterior tibial muscle lies within the calf and goes behind
the inside ankle (medial malleolus) and attaches to a bone in
the foot called the navicular bone. When the navicular bone
starts to move from its normal position, toward the ground a
person’s arch begins to collapse. The main tendon that keeps the
navicular bone in the proper position to maintain the
medial
arch of the foot is the posterior tibial tendon. If the
posterior tibial tendon is torn, stretched, or loses strength,
the navicular bone drops and a flat foot starts to develop. This
can cause not only pain at the navicular bone where the
posterior tibial tendon attaches, but also along the whole arch,
especially with walking or running. Realize just a lot of
standing, walking or running, especially if a person is
overweight, can cause the posterior tibial tendon to degenerate.
It just gets tired and worn out. You don’t need a major trauma
for the tendon to get injured and for flat feet to develop.
Standing on one foot and then standing on just the toes of the
one foot without pain is a normal phenomenon. If this is
difficult or painful on one side, especially along the arch or
navicular area, this is a sign that the posterior tibial tendon
is in trouble. You know I like palpation. Where is the foot
tender? If it is tender where the posterior tibial tendon
attaches then we suspect the patient has a posterior tibial
tendon injury. If the whole arch is painful, then the whole arch
is weakened. This begs the question - What is a person to do
if their flat foot is painful or the posterior tibial tendon is
injured?
Most traditionally-minded physicians give the patient an
anti-inflammatory
medication, tell
them to ice the area, limit activities, and perhaps try some
physical therapy or an orthotic inside their shoe. You know as
well as I do, all of these treatments (perhaps besides
exercises) do nothing to strengthen anything. At best, they give
temporary relief. Why not strengthen the posterior tibial tendon
and medial arch? Isn’t the pain caused by the arch and posterior
tibial tendon becoming weakened? What is the best treatment to
strengthen a connective tissue such as a ligament, tendon or
fascia? Yes – you know it!
Prolotherapy.
Prolotherapy, in my opinion, is the best alternative treatment
for a painful flat foot! Let me say it another way: Prolotherapy,
in my opinion, is the best alternative treatment for a genetic
painful flat foot or one that is flat because the posterior
tibial tendon is injured. Prolotherapy to the weakened tissues
will stimulate them to repair. Prolotherapy is a treatment that
stimulates the body to repair painful areas. It involves the
injections of substances that stimulate the immune system to
come to the area to repair the injured tissue and start the
natural healing inflammatory reaction. The goal and end result
is stronger collagen which makes up ligaments and tendons. This
is what the person with a painful arch needs. Typically three to
eight treatments are needed.
More good news! The patient can exercise while getting
Prolotherapy. We typically encourage patients to purchase Yogi
Toes (available at
www.benuts.com) and do exercises with them. Yogi Toes are
worn between the toes and the person is asked to contract and
extend the toes for about 10 minutes each day. This helps
strengthen some of the muscles of the foot. Also instead of
orthotics, we typically recommend strengthening the arch by
walking on a Bosu ball, in sandals, or in bare feet. Yes,
initially this may hurt, so only do it for a few minutes at a
time. Eventually the foot will be so strong that many can do
this for an hour without pain! While I can not guarantee that,
success with Prolotherapy for posterior tibial tendon injuries
and painful flat feet is the norm at Caring Medical!
Prolotherapy can make the foot stronger and provide you with
stronger soft tissue. Stronger collagen. Stronger posterior
tibial tendon tissue. So the next time your foot hurts, consider
getting Prolotherapy. For most people with a painful flat foot
it is the right choice! |