Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with progressive medial arch collapse and associated midfoot/hindfoot pain. Symptoms exacerbated by prolonged weight-bearing and ambulation. Reports fatigue in the foot and ankle region, with occasional radiation of discomfort to the medial malleolus. No history of acute trauma; onset is insidious.
Clinical Examination Findings
Physical exam reveals loss of the medial longitudinal arch in weight-bearing position. "Too many toes" sign positive on affected side. Hindfoot valgus deformity noted. Flexibility of the subtalar joint assessed; manual correction of the arch is [flexible/rigid]. Tenderness noted along the posterior tibial tendon insertion. Gait analysis shows pronatory collapse during stance phase.
Treatment Protocol
Conservative management initiated: prescription of custom orthotic inserts for medial arch support, activity modification to reduce high-impact loading, and physical therapy focusing on posterior tibial tendon strengthening and gastroc-soleus stretching. NSAIDs prescribed for pain management. Follow-up in 6 weeks to assess clinical response.