Flatfoot, also known as flatfeet, is a common condition, in which the arches on the inside of the feet flatten when pressure is put on them. When people with flatfeet stand up, the feet point outward, and the entire soles of the feet fall and touch the floor.
Flatfeet can occur when the arches don’t develop during childhood. It can also develop later in life after an injury or from the simple wear-and-tear stresses of age.
Flatfoot is a complex disorder, with a lot of symptoms and varying degrees of deformity and disability.
There are several types of flatfoot, all of which have one characteristic in common: partial or total collapse (loss) of the arch. Other characteristics shared by most types of flatfoot include toe drift, in which the toes and front part of the foot point outward, heel tilts toward the outside, and the ankle appears to turn in.
A tight Achilles tendon, which causes the heel to lift off the ground earlier when walking, may make the problem worse, bunions and hammertoes may also develop as a result of a flatfoot.
Flexible flatfoot
Flexible flatfoot is one of the most common types of flatfoot. It typically begins in childhood or adolescence and continues into adulthood. It usually occurs in both feet and 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. The term “flexible” means that while the foot is flat when standing (weightbearing), the arch returns when not standing.
Symptoms
Symptoms that may occur in some people with flexible flatfoot include:
• Pain in the heel, arch, ankle or along the outside of the foot
• Rolled-in ankle (overpronation)
• Pain along the shin bone (shin splint)
• General aching or fatigue in the foot or leg
• Low back, hip or knee pain
Diagnosis
In diagnosing flatfoot, the podiatrist examines the foot and observes how it looks when you stand and sit. X-rays are usually taken to determine the severity of the deformity. If you are diagnosed with flexible flatfoot, but you do not have any symptoms, your podiatrist will explain what you might expect in the future and how to support your feet.
Nonsurgical treatment
Flatfoot is usually painless. If you aren’t having pain, for most people no treatment may be necessary. However, if flatfoot is causing you pain, deformities, limiting your activity or what you want to do, or giving you trouble finding shoes, then an evaluation from a specialist may be needed.
If you experience symptoms with flexible flatfoot, your podiatrist may recommend nonsurgical treatment options, including:
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.
Orthotic devices: Your foot and ankle surgeon can provide you with custom orthotic devices for your shoes to give more support to the arches.
Immobilization: In some cases, it may be necessary to use a walking cast or to completely avoid weightbearing.
Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, help reduce pain and inflammation.
Physical therapy: Ultrasound therapy or other physical therapy modalities may be used to provide temporary relief.
Shoe modifications: Wearing shoes that support the arches is important for anyone who has flatfoot.
Ankle foot orthoses (AFO) devices: Your foot and ankle surgeon may recommend advanced bracing to modify your walking and to support your arches.
Surgery
In some patients who continue to have pain and the treatments cannot relieve it, surgery may be considered. Many surgical techniques are available to correct flexible flatfoot, and one or a combination of procedures may be required to relieve the symptoms and improve foot function. In selecting the procedure or combination of procedures for your particular case, the podiatrist will take into consideration the extent of your deformity based on the x-ray findings, your age, your activity level and other factors. The length of the recovery period will vary depending on the procedure or procedures performed.
• For more information visit www.apma.org or email foothealth242@gmail.com. To see a podiatrist visit Bahamas Surgical Associates Centre at Hilltop Medical Centre, Centreville or call 603-1814/15/16 for an appointment. In Grand Bahama, visit Lucayan Medical Center call 373-7400 for an appointment.
