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Flat Feet Can Cause Significant ProblemsIntroductionFlat feet is the most common foot deformity known. In fact, 25% of the U.S. population has flat feet. Some of these people may experience problems that limit their activities, while others can run marathons. The good news is that the vast majority of cases, especially in children, require only conservative (non-surgical) treatment, if any at all. Not all flat feet cause problems. Those that do, however, can lead to a variety of problems including heel pain, tired feet, bunions, knee pain, back pain and arthritis. In fact, several medical studies point to a close relationship between flat feet and arthritis of the foot and ankle. What Causes Flat Feet?Flat foot can be present at birth or can be acquired later in life. Acquired flat foot, develops over time. Many different factors can contribute to the development of flat feet. These include the types of shoes a child wears, a child's sitting or sleeping positions, compensation for other abnormalities further up the leg, or more severe factors such as rupture of ligaments or tendons in the foot. A common cause for flat feet is that the foot is compensating for a tight Achilles tendon. If the Achilles tendon is tight, then it causes the foot to pronate – or flatten out. The most common acquired flat foot in adults is due to a rather serious condition called Posterior Tibial Tendon Dysfunction. This develops with repetitive stress on the main supporting tendon of the arch over a long period of time. As the body ages, ligaments and muscles can weaken, leaving the job of supporting the arch all to this tendon. The tendon cannot hold all the weight for long, and it gradually gives out, leading to a progressively lower arch. This form of flat foot is often accompanied by pain behind the ankle, consistent with the course of the posterior tibial tendon. Making matters worse is that the human foot is not designed to withstand the types of forces it is subjected to today. The fact that Americans on average weigh more than ever before puts tremendous stress on feet. Also, we live for the most part on hard, flat surfaces.. This type of surface puts continual unnatural stress on the foot. Finally, we are simply living longer than we used to, meaning that not only does the arch deal with heavy weight on hard flat ground, but also must now do so for longer periods of time. This is why you must take care of your feet now in order to prevent problems later. Treatment OptionsJust as there are many different causes of flat feet, there are also many different treatment options. The most important aspect of treatment is determining the exact type or underlying cause of flat feet that you have. Our foot and ankle specialists can determine this through thorough clinical examination and special imaging studies (e.g., x-rays, computed tomography, and/or magnetic resonance imaging). Conservative treatment is effective in the vast majority of flat foot cases, and consists of treatments such as insoles, splints, manipulation, or casting. Surgery is rarely required, and is reserved only for the most severe types of flat foot that do not respond to conservative therapy. Adult Acquired Flat Foot Treatment: Acquired flat foot is an entirely different entity. The best way to treat acquired flat foot is to never acquire it in the first place. This is where proper, well-made and well-fitting shoes come into play. Arch supports – either over-the-counter or custom can also help prevent the onset of the adult flatfoot. If you have already acquired flat feet, again the treatment is based on the exact type of problem that you have. If we determine a tight Achilles tendon to be the cause, then we may prescribe some combination of stretching and strengthening exercises or possibly physical therapy and orthotic devices. If Posterior Tibial Tendon Dysfunction causes your flat foot, conservative measures may include rest, immobilization, shoe modifications, orthoses, bracing, and anti-inflammatory medications. Depending on the severity, we may deem it necessary to cast your foot while the tendon heals. Because Posterior Tibial Tendon Dysfunction is progressive (worsening over time), it is essential to seek medical attention early, as conservative measures tend to fail in the later stages of dysfunction. Wonderful World of Orthoses: You may have noticed that one common element in the conservative treatment of all types of flat feet is orthoses. Depending on your problem we may recommend OTC orthoses or custom functional orthotics. In some more severe cases, an ankle-foot orthoses may be necessary. Surgery: Flat feet that do not respond to conservative therapies, remain painful, and/or continue to cause other problems, may require surgery. The surgical procedure selected is entirely dependant on the type and severity of flat foot, as well as the age of the patient. Again, before surgery, all conservative treatments should be tried. If surgery has been recommended, see us before proceeding with surgery. We surprise many patients with our ability to treat even severe flatfoot deformities in a conservative manner.
The doctors at the Foot and Ankle Center of Washington are among the
Puget Sound area’s best and most experienced in treating flat feet both
conservatively and surgically. Don’t live with pain due to flat feet.
Call today for an appointment in our Seattle office.
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