Flat Feet and activity of Proteolytic Enzymes

Barry Francis the foot surgeon at the Fyfield Clinic London picked out this storie in a recent edition of the Nursing Times, discussed the possibility that adult acquired flat feet may be caused by the activity of proteolytic enzymes.  According to the article put out by the Press Association, researchers at the University of East Anglia found that the increased activity of these enzymes can break down the constituents of the tibialis posterior tendon and weaken it, causing the foot arch to fall.  This condition, which often goes undiagnosed, is most common in women over 30 and occurs when the tibialis posterior tendon gradually stretches out over time.  The researchers say that their study marks an important advance in understanding the causes of adult acquired flat feet and may eventually lead to a new drug for the condition.  The findings may also be useful in developing treatments for other common conditions such as Achilles tendonitis.  However, it is stressed that new treatments could be 10-15 years away.  Further research is needed to find out which proteolytic enzyme should be targeted and whether people could be genetically predisposed to this type of tendon injury.  Lead author Dr Graham Reilly said “our study may have important therapeutic implications since the altered enzyme activity could be a target for the new drug therapies in the future.  If shown that similar changes also take place in other painful tendon conditions such as Achilles tendonitis, this advance may ultimately result in an effective alternative to surgery for many patients”.  I gather that the complete findings are published in the Journal Annals of Rheumatic Diseases.

Barry Francis  “The Foot Surgeon”  Fyfield Clinic London.

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