Flat FeET

What Is Flatfoot?

· Partial or total collapse (loss) of the arch.

· Adults who are overweight frequently have flatfoot.

· Arches tend to fall with age and after pregnancy due to loosening of the ligaments supporting the arch bones

Other characteristics shared by most types of flatfoot include:

· “Toe drift,” where the toes and front part of the foot point outward

· The heel tilts toward the outside and the ankle appears to turn in.

· A short & tight Achilles tendon

· Bunions and hammertoes may occur in some people with flatfeet.


Flexible or Rigid Flatfoot?


· It typically begins in childhood or adolescence and continues into adulthood. It usually occurs in both feet and generally progresses in severity throughout the adult years. As the deformity worsens, the soft tissues (tendons and ligaments) of the arch may stretch or tear and can become inflamed.

· With “flexible” flatfoot the arch returns when not standing. In the early stages of flexible flatfoot arthritis is not restricting motion of the arch and foot, but in the later stages arthritis may develop to such an extent that the arch and foot become stiff.

· In “rigid” flatfoot, some of the foot bones become fused and little or no motion occur beneath the ankle joint.  This type is rare and usually found in the teen years.

· Another type of flatfoot is “acquired”, usually occuring in adults who have sustained an injury to a tendon that helps support the arch, resulting in Posterior Tibialis Tendon Dysfunction (PTTD) or adult acquired flatfoot deformity.


What are the symptoms?

Symptoms, which may occur in some persons with flexible flatfoot, include:

· Tired & fatigued arches

· Pain in the heel, arch, ankle, or along the outside of the foot

· “Turned-in” ankle

· Pain associated with a shin splint

· General weakness/fatigue in the foot or leg

· Difficulty raising up on the balls of the feet

Diagnosis of Flexible Flatfoot

· Your foot specialist will examine your feet and may observe how they look when you stand and sit.

· X-rays may be required to determine the severity of the disorder and stage of arthritis if any.


 Treatment Options

· Activity modifications. Cut down on activities that bring you pain and avoid prolonged walking and standing to give your arches a rest.

· Weight loss. If you are overweight, try to lose weight. Putting too much weight on your arches may aggravate your symptoms.

· Custom Orthotics & Braces. Your foot specialist can provide you with braces or custom orthotic devices for your shoes to give more support to the arches and hold your foot in a more neutral allignment.

· Immobilization. A walking or plaster cast to completely avoid weight-bearing.

· Medications. Drugs called NSAIDs may be prescribed to decrease inflammation of tired foot muscles

· Physical therapy. Ultrasound and phonophoresis may help to promote healing by reducing inflammation and pain.

· Orthopedic Footwear. Wearing shoes that support the arches is important for anyone who has flatfoot.

· Surgery. In some patients whose pain is not adequately relieved by other treatments, surgery may be an option. Surgical techniques are aimed at relieving the symptoms and improving foot function. The length of the recovery period will vary, depending on the procedure performed.