Flat Feet

A common but highly variable condition

Fallen arches is a layterm for flatfoot, or pes planus, a condition in which the longitudinal arch of the foot does not develop normally and is lower or flatter than expected.  It is often misunderstood and misconstrued as a deformity that should always be corrected.  This is not true in all cases. There is a distinct difference in the painful vs. the non-painful flatfoot.  Many flatfoot conditions are inherited, especially when seen in children, but may also be due to an injury or other systemic conditions.  As most flatfoot conditions are self-limiting and non-progressive, treatment is often based on management of mild aching symptoms in the feet and proper shoe gear selection with good supporting arches.  Some over-the-counter arch supports will adequately support the arch of the foot. If this fails, Custom Orthotics , can be fabricated to control the excess motion of the flatfoot as well as properly support the fallen arch.  This will often help alleviate symptoms such as arch pain, heel pain, aching legs, foot fatigue and pain in the ball of the feet and may slow down tendon pathology and arthritis by reducing the excess stress on the tendons and joints.  Stretching the calf muscle can also be beneficial in some cases.

The painful flatfoot, is more difficult to manage and may even require surgical treatment.  The painful flatfoot usually defies conservative care.  Although the measures mentioned above for the nonpainful foot are often tried, the painful flatfoot is progressive and continues to be painful and can be limiting to daily activities despite attempted care. In the child, this may be seen with a very tight heel cord ( Equinus ) or a rigid collapse of the arch that can not be lifted with arch supports.  In the adult, this may be seen with the tearing of a tendon so that it can no longer support the arch and the foot continues to collapse ( Adult Acquired Flatfoot ).  These situations often call for surgical care such as tendon lengthening, tendon repair, reconstruction of the arch bones and straightening of the heel.

When in doubt as to the underlying cause of the “flatfoot”, it is often best to seek the advice of a foot & ankle specialist as early intervention can often mean the difference between long term complications and disability and the full return of activity without pain. Our clinic specializes in the complex flatfoot that is does not respond to standard conservative treatments.