It is a normal phenomenon for the foot to get larger over a
lifetime of use. Ligaments lose their
tensile strength and tendons can lengthen over time making the shape and size
of the foot change. However, these
changes happen over a long period of time, making them unnoticeable from month
to month. The only situation is which
noticeable changes happen normally would be in pregnancy, since women have
hormones in their body which are meant to make ligaments more flexible to allow
for child birth. But have you noticed
that your arch has slowly but noticeably flattened over a period of
months? If so, you may have a condition
termed Posterior Tibial Tendon Dysfunction or PTTD.
The posterior tibial muscle is the main muscle that supports
the arch of the foot. The tendon runs on
the inside of the leg right behind the inside of the ankle. It is the main muscle that allows you to turn
the sole of one foot in so that it is facing the other foot. In certain foot types, this muscle can be
subject to a significant amount of force, causing over lengthening and
breakdown of the tendon. If the tendon
degenerates or loses its strength, the muscle loses its ability to hold the
arch up. With time, the arch slowly
loses its height, causing pain and difficulty fitting in shoes. This process may not produce enough
discomfort to push you to see a podiatrist until some irreversible damage has
already been done. There are different
stages of PTTD, thus the treatment depends on how degenerated the tendon
is. In most cases, an MRI is needed to
assess the current status of the tendon.
