Pes planus, or flatfoot, is a complex disorder that involves partial or complete arch collapse. There are various causes, but in most forms, the toes and heel point outward and the ankle appears to turn in.

Flexible flatfoot typically begins in childhood and progresses into adulthood.  ‘Flexible’ means that the arch disappears while standing, but reappears when not standing. As time goes on, the soft tissues (tendons and ligaments) can stretch out or tear, causing increased pain and inflammation. Other types of flat foot are rigid flatfoot, where there is no arch with sitting or standing, adult acquired flatfoot (“fallen/collapsing arches” or posterior tibial tendon dysfunction), and pediatric flatfoot.

Symptoms:

Some people with flat feet do not have symptoms, but others may have some of the following:

  • Pain in the arch, heel, or along the outside of the foot/ankle
  • A rolled in ankle (overpronation)
  • Shin splints (pain along the shin bone)
  • Knee, hip, or low back pain
  • Achiness or generalized fatigue in the foot and lower leg.
  • Children at play may tire more quickly than their peers.

Diagnosis:

Your podiatrist will examine your foot while you stand and sit. You will likely have x-rays taken to further evaluate the extent of the problem.

When Do I Need Surgery?

Surgery may be an option if other treatment options are not working.  A combination of procedures may be needed to correct the deformity and improve pain and foot function.  Your foot and ankle surgeon will take into account your symptoms, x-rays, and other factors when deciding which surgery is best for you.

Treatment:

Depending on your type of flatfoot, your podiatrist may recommend one or more of the following:

-Decrease activities that cause your pain, such as prolonged walking and standing.

-Wear shoes with good arch support.

-Custom orthotics (shoe inserts) or ankle braces can be prescribed for better arch support.

-Sometimes immobilization in a boot or cast is needed to allow your foot to rest.

-NSAIDs (nonsteroidal anti-inflammatory drugs) like ibuprofen can help reduce pain and swelling.

-If you are overweight, trying to lose weight may decrease your symptoms.

-Physical therapy can use ultrasound or other methods to provide relief.