Enzymes Implicated as Potential Cause of Flat Feet

A team of researchers led by the University of East Anglia (UEA) in the United Kingdom has made a new advance in understanding the causes of adult-acquired flat feet.

Adult-acquired flat feet, which most commonly affects women ages 40 and over, is the result of the gradual stretching of the tibilias posterior tendon, the main stabilizer of the foot. The causes of the stretching are not fully understood, although wearing high heels and standing for extended periods of time are often associated with flat feet. Other risk factors include obesity, hypertension and diabetes.

The study, conducted in conjunction with surgeons and scientists at Addenbrooke’s Hospital in Cambridge and the University of Bristol, found that the structure and composition of tendon specimens changed in patients with flat feet. There was also evidence of increased activity of some proteolytic enzymes, which can break down the tibilias posterior tendon and cause the foot arch to fall.

The study was recently published in the Annals of Rheumatic Diseases, according to a press release.

“Our study may have important therapeutic implications since the altered enzyme activity could be a target for new drug therapies in the future,” Dr. Graham Riley, the lead author from UEA’s School of Biological Sciences, stated in the release. “We have shown that similar changes also take place in other painful tendon conditions such as Achilles tendonitis, so this advance may ultimately result in an effective alternative to surgery for many patients.”

He noted that further research was needed to fully determine which proteolytic enzymes should be targeted.

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