Flat Feet
What Are Flat Feet?
Flat feet, also known as fallen arches, is a common foot condition in which the entire sole of the foot makes contact with the ground when standing. In a normal foot, the arch creates a gap between the inner side of the foot and the ground, providing natural shock absorption and distributing body weight effectively. With flat feet, this arch is either very low or completely absent.
Flat feet most commonly occur when the arch of the foot does not develop properly during childhood. However, the condition can also develop in adulthood when the arch gradually collapses over time. This happens as tendons in the ankles and feet weaken from aging, wear or tear, or injury. The posterior tibial tendon, which runs along the inside of the ankle and helps support the arch, plays a crucial role in maintaining foot structure. When this tendon becomes damaged or weakened, the arch can progressively flatten.
Several factors can increase the likelihood of developing flat feet. Obesity places extra stress on the feet and can contribute to arch collapse. Diabetes may affect the nerves and tissues in the feet, increasing risk. Rheumatoid arthritis can cause inflammation and damage to the joints and tendons supporting the arch. Serious injuries to the ankle or foot, such as fractures or tendon ruptures, may also lead to flat feet. Additionally, pregnancy and aging are natural risk factors as hormones and time can weaken supportive tissues.
Many people with flat feet experience no symptoms and require no treatment. However, others report various symptoms including aching pain in the arch or heel, discomfort in the lower legs or back, difficulty rising on tiptoes, and feet that tire easily. Some individuals notice swelling along the inner ankle or find that their feet roll inward excessively when walking (overpronation). Pain may worsen with activity and improve with rest.
Nonsurgical Treatments
Most cases of flat feet can be effectively managed without surgery. Our doctors offer a range of nonsurgical treatments to help relieve pain, improve foot function, and slow the progression of arch collapse.
Lifestyle Modifications
Rest is important when flat feet cause pain or discomfort. Limiting high-impact activities and avoiding prolonged standing or walking can help reduce symptoms. Weight management is particularly beneficial for individuals with flat feet, as reducing excess weight decreases stress on the feet and may slow arch collapse. Choosing low-impact exercises such as swimming or cycling can help maintain fitness while minimizing foot strain.
Medications
Over-the-counter medications such as ibuprofen or naproxen may help reduce pain and swelling associated with flat feet. Ice application after activities can also provide relief. Patients should talk to their pharmacist before purchasing anti-inflammatories, as these medications may be contraindicated or may interact with other medications and medical conditions.
Physical & Occupational Therapy
Physical therapy exercises can both stretch and strengthen the muscles of the feet and lower legs. A structured therapy program may include calf stretches, arch strengthening exercises, and exercises to improve ankle stability. These interventions can help support the arch, reduce pain, and improve overall foot function.
Supportive & Assistive Devices
Changing to footwear that offers additional arch support is one of the most effective treatments for flat feet. Shoes with good arch support, a firm heel counter, and adequate cushioning can significantly reduce discomfort. Orthotic inserts or custom-made orthotics may provide additional relief for tired or aching feet by supporting the arch and distributing pressure more evenly. Over-the-counter arch supports can be helpful for mild cases, while custom orthotics designed specifically for an individual's foot structure may be beneficial for more severe symptoms.
Surgical Treatments
Surgery for flat feet is typically reserved for cases where nonsurgical treatments have failed to provide adequate relief and the condition is accompanied by other serious foot problems. The right surgical approach depends on the underlying cause of the flat feet, the severity of deformity, and the presence of associated conditions such as tendon damage or arthritis.
Tendon Repair or Transfer
If the posterior tibial tendon is severely damaged and causing progressive arch collapse, surgery may involve repairing the damaged tendon or transferring a nearby tendon to restore support to the arch. This procedure can help halt further deterioration and may improve foot function.
Bone Realignment Procedures
Various surgical procedures can be performed to realign the bones of the foot and recreate a more normal arch. These may include cutting and repositioning bones (osteotomy), lengthening the outer column of the foot, or fusing certain joints to provide stability. The specific procedure chosen depends on the individual's foot structure and the underlying cause of the flat feet.
Arthrodesis (Joint Fusion)
In cases where flat feet are accompanied by severe arthritis in the foot or ankle joints, fusion of one or more joints may be necessary. This procedure eliminates painful motion in damaged joints and can help restore a more stable foot structure. While fusion reduces some motion, it can provide significant pain relief and improve function in severe cases.