High arch feet.... surgery?

[laxbear]

Hi all... does anyone here has high feet arch and has problem with them? Recently I has my appt with orthopedic doc and I told him about my feet problem. I get pain in them everyday, side of toes, ball of big toe, top of feet(top of arch), side of arch...

He did some manual tests on my feet and concludes that the nerve outside of both my leg/feet is weak and wants to send me for EMG test. Does anyone have this test before? I also have a high arch as the Xrays shows.

He says there's a condition which causes this nerve weakness but didn't say what though. He gave me 2 options, orthotics and surgery(last resort)... I already had 3 orthotics made-all didn't helped.

I heard about a lot of ppl with flat feet... but not sure about high arch feet. Did you have surgery done for your feet problem?

Any experience is appreciated.

[laxbear]

Does anyone here has high arch feet or flat feet is more common among hypermobility people/in general?

[Flora]

Hi laxbear,
flat feet are more common in people with hypermobility, because the small joints in the foot are normally looser and the foot flattens when standing etc. The foot often has a normal arch when not bearing weight. From what I have read having a high arch and HMS is really not that common.
Sorry I can't be of more help.
flora

[Sue New]

Hi There,

I have really high arches when non weight bearing - when I was studying ballet, my dance teachers were always amazed at how much my feet arched, but as soon as my feet touch the ground they go flat and the bones spread out.

Sue.

[paw]

I am NOT a doctor. I used to work for a foot surgeon and I never heard of surgery to reduce a high arch. My doctor/boss did not do this surgery. Maybe that is not the surgery your doctor is talking about doing? I am concerned about the idea because people with hypermobile joints and poor ligaments don't heal well after surgery in many cases.

What my doctor would tell people with problems like you describe is to try cushioned insoles, not just pharmacy ones, but made from special materials that absorb shock and mold to your particular feet. He would also make sure that you were wearing supportive shoes that fit correctly. He often had people wear the insoles on top of orthotics for comfort.

If you have nerve pain, they really have few options to treat that. One friend is taking a medication called lyrica (Pregabalin) and it did help her. She had an accident and extensive leg and foot surgery and a lot of nerve damage. I hope you have the EMG and find out the function before you consider surgery, and that you get a second opinion.

[laxbear]

Thanks for all the replies, really appreciated that.

My arch is higher without weight bearing but there's still a high arch when I stand on my feet. So I guess it flats out a bit but not that much till it's normal arch. I can't wear nice lady shoes or flat shoes(with/without some arch support), it just makes my feet hurt really badly. There are so many limitations when it comes to buying shoes.

I have the positive thumb sign; I also realised that a few of my fingers are turned to the side instead of being straight on both hands.

I had the Nerve condution study done 2 days ago but they didn't continue to do the EMG. I am guessing that means the test was negative so they didn't need to continue with the EMG. Anyway, I will ask my doctor about the NCS result on the next appt.

Yes, my ortho doctor says that the surgery is to flatten the high arch. I found online that adults with flat feet is about 20% to 25% and those with high arch is very much smaller percentage. No wonder so many doctors I have seen know so little about my problem until I was referred to this new ortho surgeon that specialises in ankle and foot problems. I nearly gave up hope... it's so frustrating being thrown from one doctor to another and not getting answers. Including my hypermobility, they don't seem to take it seriously and just said that I have to live with it and just do exercise and good bye.

I'm also worried that the surgery might make my feet problem worse and that the liagments will not heal properly. My knees are also turned inwards(causing pain) and I'm wondering anyone here has that too.

I have all my insoles custom made. Some are done local in the hospitals while others are sent overseas to be made. My feet problem has been with me for more than 10 years and it started when I was around 9.

I also found out that the weakness I have in my leg is called peroneal muscle weakness.

[paw]

Have your doctor go over this in great detail exactly how this surgery will help you. What can you expect in terms of benefit and risk, are there any other possible treatments. I am still very concerned that it could cause more damage to the ligament if you have HEDS and your doctor is thinking you will react and heal like a "normal" person.

Please get second opinions from another doctor who is very skilled before you decide to have this surgery. If you already have muscle damage and weakness, I would not want to risk more damage by this surgery unless they can realy give hope for a very good outcome. It just worries me.

I hope they can find non-surgical ways to help you. Even custom made shoes may be better than possible permanant damage to your foot.

[Amazon]

I have extremely high arches - you're not alone

I score 9/9 on the hypermobility scale, plus I have a hypermobile TMJ and other joints which aren't part of the assessment.

I'm lucky though - my feet don't cause me any problems really (apart from trying to get shoes that fit!), I walk a lot and also do Pilates to strengthen everything up.

I'm currently undergoing lots of different tests to see if my hypermobilty is due to Marfan syndrome (I'm 6ft tall) and I know that although flat feet are the most common thing with this condition, but high arches are present in a significant number of patients.

I hope you get your feet sorted out soon

[Janene]

I'm a new member only diagnosed with HMS in february this year. I also have extremely high arches. I had read that flat feet were the norm with HMS and was perplexed. I'm glad to see that there are some of us out there with the opposite problem. I have lots of trouble with my feet. I have orthotics specially made for the shape of my feet because store bought ones don't even reach my arch and are useless. If I wear my orthotics with good shoes I have much less of a problem but I hate wearing shoes all the time around the house.
I find that any weight bearing excercise such as walking alot really aggravates my feet. They feel their best when I wear my orthotics as much as possible and don't over excercise them. I'd be very careful when it comes to any surgery to correct this problem. I'd be inclined to persever with the orthotics and rest your feet as much as possible.
I really hope you get some relief soon as I know how painful it can be.

[laxbear]

I'll sure ask my ortho surgeon more about the surgery. I have been to so many doctors and finally I found someone that could give me some answers at least and it would be hard for me to go and look for another specialised doctor. The other previous doctors I saw gave me confusing information. I asked them whether my arch are high and he said 'no', it's normal, but I was told by my previous physiotherapist and podiatrist that I have. I have no one else to talk to and can understand how I feel except through message boards online and researching online to find more information(not much about pes cavus that I can find).

I'm not officially dx with HEDS but I sure do have the lax joints. I'm going back to see my ortho surgeon next week. So I'm getting really the list of questions to ask him. Anyone has ideas what important questions should I ask?

Amazon, I have been through tests for Marfans. I have the marfanoid haibitus but they said I do not have the syndrome as there's no family history and that my heart looks fine. So when will you know the result?

Take care everyone!

[paw]

Anyone has ideas what important questions should I ask?

1. Do you plan to cut or alter the plantar fascia ligament? In what way?
2. How long is the recovery period?
3. Do you plan to take special precautions due to my PROBABLE EDS and possible healing complications? Are you aware local anesthesia may not work on me? What is your plan if it does not work?
4. How soon can I walk? Will I be in a cast, brace, or special shoe? Will I have stitches, and where will they be? How many stitches are normally done?
5. When would you do the second foot?

Actually if the doctor said he/she planned to cut or alter the plantar fascia that would be the end of the discussion for me. The foot surgeon I worked for said that any surgery on that ligament is extremely painful (much more than bone work) and that he would not do it. It usually did not have a good outcome for the patient.

They may have some new surgery developed since I worked for this doctor. I am only stating my opinion that my doctor boss did not feel that surgery was the way to treat this problem. He would have used orthotics (custom made) and cushioned insoles and the right shoes. Even if the shoes had to be special made to allow more room for the shape of the foot.

His office saw lots of patients with high arch and none ever had surgery to fix it. Things may be different in the UK. I am worried they will damage your foot so you CAN'T walk, and will have extreme pain. Once they cut that ligament, (possibly they will call it a Z slide tenotomy) it will be thinner and possibly break. People with EDS heal slower and their ligaments are weak already, so cutting would put you at more risk than *regular* patients.

My doctor would do tendon lengthening on the top of the foot (tendons that contract the toes) so I know exactly what they do, he just said it was a bad idea on the bottom of the foot, that healing is very slow and extremely painful. Best of luck to you. I hope they don't plan to cut the plantar fascia. Are you strong enough to be on crutches for several months? They would not work on both feet at the same time, normally they do one, wait till it has healed and then do the second surgery. If you have shoulder problems, crutches will be a problem.

[nonyanomemory]

This link may help - but requires careful reading. link

I have been told that I should have knee reconstruction surgery involving tendons being taken from elsewhere but due to HEDS they will not perfom the procedure for the very reasons paw has mentioned above. I am not a doctor so have no medical knowledge but my tendancy would be for myself to leave surgery as a very last resort.

nonya

[laxbear]

Thanks for the questions and the link to the website, they are informative but I don't understand everything.

paw, you mentioned that cutting the plantar fascia ligament is a big no-no for people like us, and that the outcome is not good scares me. I will certainly ask my doctor more about this and if he has the idea of doing that.

I get the pain even when I'm not on my feet. I also get them when I wake up in the morning; and standing in the shower makes my feet and knees hurt. My feet are also very 'floppy'.

My shoulders do sublux but they shouldn't be a big problem as they are not in terrible pain.

Anyway, I really hope there's something else my doctor can do. All these surgery stuffs and not knowing if my feet will be better or worse after surgery is scary . I have been living with this feet pain for more than 10 years and can't imagine having to live with it for the next 50 years. Finding shoes is also absolutely hard...

Thanks for listening. I know there are other HMSers that are in much worse condition than me.

[paw]

We all have our own issues and some are worse than others but that does not make YOUR'S any less real. I am glad you will be asking more questions before you decide to have surgery.

I have to wonder if there are exercises to make the feet stronger? My doctor boss told people to do raises up on their toes, use ice on the arch, and work with a stretcy band. PLEASE make sure to talk to yout doctor or physio therapist before you start exercises to make sure they are the right ones for your feet.

Take care of yourself.

[laxbear]

Hi, I just went to see my ortho surgeon recently and the test results for the NCS is negative - yay! no nerve damage in my leg.

But he tells me that I need surgery and since the orthotics didn't help me. I asked if there are any other ways and he said 'no'... perhaps 'pop' painkillers forever. I don't like taking meds and depend too much on pain meds, so that's out for me. I have no one to turn to and share this with and I am just feeling so 'blank'!

He explained the procedure, risk and outcome to me and I just feel so confused at what I should do next. Below are the 4 different procedures that he will do at the same time:

1) Plantar fascia release
He says it will be cut off - from what I understand is, it will be totally cut off and since he says I have lax joints, I asked him if this procedure will affect my healing or anything. He says that usually it(PF) is not needed and I will do fine without it. Because my arch will be lowered, the plantar fascia will be tight so he has to release it...
2) Dorsal displacement calcaneal osteotomy
3) Dorsiflexion osteotomy of 1st tarsal-metatarsal
4) Excision of joint bunion
-I will need metal plates and screws.

He will operate on my right foot first and if I like the result then I go onto left foot. It will be a pretty major op and I will be under GA and est stay of 5 days in hospital.

There will be 4 incisions and each about 4-5cm. I'll be in a orthopedic 'ski-boot' for around 6 weeks.

Risks/complications are... bone might not heal/grown back and I might need surgery again to take bone from my hip and put onto my bone, infection, GA risk, incisions not healing well, implants might be visible and painful and might need surgery to remove them. Is there any data that the bone of someone with hypermobiloty heals badly? I know I scar badly so since I will have 4 incisions, I can't help thinking that my foot will look like a war zone! My skin is thin and translucent, very little flesh too...

Surgery will not be 100% successful as it's a complicated surgery and one never knows the real outcome until after that. He told me that it will be around 80-90%. He also said that even though if I don't get full relief of pain, I will defenitely feel better than now.

I am so confused now and keep thinking if I really need this surgery. It's not like I'm in a wheelchair and can't walk but I defenitely have pain every single day. I can't imagine living for the rest of my life with foot pain and I already have other joint pain here and there to cope with. I feel so... ...

I'm going to come out with another list of questions to ask him and any help/suggestions from yall will be greatly appreciated!