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Flat Feet

Pes planus (or pes planovalgus) is the medical term for flatfoot. Flatfoot is a very common disorder that may lead to pain in the foot and ankle. It describes a foot which has a low or “flattened” arch. There are varying degrees and various types of flat feet.

This condition occurs in children (congenital flatfoot) as well as in adults (acquired flatfoot). It is common to see a normal arch while sitting, but upon standing, the arch may flatten. This can give the appearance of the ankle rolling in and the heel rolling out. This process is called “pronation.” The toes may also point outwards. One may also develop bunions and hammertoes.

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Most flatfoot conditions are flexible (mobile) while a few are rigid. Rigid flatfoot usually is caused by a tarsal coalition (two of the bones in the rearfoot are connected together) in adolescents and adults, and by vertical talus (very complex deformity often requiring surgery) at birth. Flexible flatfoot is typically hereditary and can be caused by a tight calf muscle or laxity (flexibility) of the ligaments.

Not all flatfoot conditions cause pain. When symptomatic, it is often described as a tired or weak feeling in the arch or ankle after being on the feet for a short duration, pain on the inside of the ankle or arch, shin splints, or pain in the ankles. A podiatrist will be able to evaluate, diagnose, and treat these conditions. They will be able to get proper tests such as x-rays to assist with the diagnosis and the degree of the deformity.

Treatment will typically start with conservative therapy. These may include shoegear modifications, orthotics, stretching exercises, and physical therapy. Activity modifications, anti-inflammatory medications, and icing may also be treatment options.

If conservative treatment is not responding, surgical correction is recommended. There are several procedures that may be utilized to correct a flatfoot deformity. The goal is to relieve the pain and improve the function of the foot. Procedures may include tendon lengthening, tendon transfers, cutting and shifting bones, fusion of joints, and implants. You podiatrist will be able to select the procedure(s) based on the level of the deformity, your age, activity level, x-rays, and clinical exam. The recovery period depends on the procedures selected, but typically range about 3-6 months.