Concluded Case

Pes Planus

25yr old male complains of pain in leg upon long hours of standing. Dx-?Pes Planus What is the management? What advice can be given?

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There looks to be a difference in both arches of foot seems. yess. there is deformity of left foot: flat foot:pes planus.loss of longitudinal arch. bcz of bony deformity..unbearable pain persist more on standing, feel tiredness after activity.feet feels stiff. due to overuse of muscles of leg and foot tend to fatigue and cramp. Treatment:conservative if not managed then surgical. Nsaid drugs.. orthotic braces AFO. Take reference of orthopaediacian.

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There looks to be a difference in both arches of foot seems. yess. there is deformity of left foot: flat foot:pes planus.loss of longitudinal arch. bcz of bony deformity..unbearable pain persist more on standing, feel tiredness after activity.feet feels stiff. due to overuse of muscles of leg and foot tend to fatigue and cramp. Treatment:conservative if not managed then surgical. Nsaid drugs.. orthotic braces AFO. Take reference of orthopaediacian.

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Look like a mobile pes planus than a rigid one Look at the arch reappearing on toe dorsiflexion by Windlass mechanism Weight bearing will further reveal collapse of arch due to loading Need xray evaluation Xray both foot ap Foot with ankle lateral, preferably in standing position Look for Secondary OA of talonavicular joint Medial arch support foot wear on regular basis Even inside the house Venous doppler to rule out varicose veins due to perforator incompetence

Stretch exercises like toe raise, calf raise, heel stretch, tennis ball rolling.. can be tried. Using brace- footwear Tab. Diclofenac 50mg sos

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Due to wrong posture standing it has to be corrected Take rest in between standing time

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? FOOT PATHOLOGY .. ? PES PLANUS .. NEED'S.. EXPERTS OPINION..

Left flat foot + Physio management Silicon heel and foot pouch Ultrasonic therapy to reduce pain and inflammation Ice fomnetation Arch lifts. Calf raises. Stair arch raises. Towel curls. Toe raises.

Measure arch in non weight bearing and weight bearing position. Is the person having flexible arch or rigid arch ? Doe sthe arch appear on standing on toes ? This will help to decide if foot accommodation to be given or not in footwear.. ergonomic advice, standing breaks, how to offload feet while standing, contrast bath for feet, strengthening program for back and lower limbs will help in long run...

Leg exercise with taking break between standing . Pour legs in warm water. Muscle strengthening would be done.

Medial foot raises Isometric excerise for foot

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