Living with Flat Feet
What Is Flatfoot?
Flatfoot is not a simple foot problem. The condition can have an assortment of signs and symptoms. Flatfoot also has several degrees of deformity and disability, making the problem different for each patient. There are also numerous flatfoot types, but they all share one thing: a partial or total collapse of the arch of the foot.
Additional flatfoot symptoms include:
- “Toe drift." This is when the toes and front portion of the foot face outward.
- The heel leans toward the outside and the ankle seems to turn inward.
- A short Achilles tendon. A short tendon causes the heel to come up off the ground earlier when the foot is in motion.
If you have rheumatoid arthritis or diabetes, your risk of developing flatfoot may be increased. If you are overweight, you are most likely at a higher risk for developing the deformity as well. Once you have developed flatfoot, Bunions and hammertoes may develop also due to the deformity.
Flexible flatfoot is one of the most frequent kinds of flatfoot seen in a podiatrist's office. Flexible flatfoot usually begins during childhood or the teenage years. It often develops in both feet and gets worse and worse as the years pass. As the deformity advances, the soft tissues, meaning the tendons and ligaments of the arch, can stretch or tear. If that happens they may become inflamed and painful.
Why is it called Flexible Flatfoot?
The word "flexible" is used because if you are standing and bearing weight on your foot, it will be flat. However, when you sit down, or when you take weight off the foot, the arch returns. Early on, arthritis isn't yet limiting the movement of your arch and foot. At a later period, however, arthritis can form and become severe enough that the arch and foot become stiff and inflexible.
How is Flexible Flatfoot diagnosed?
To diagnose the deformity, a podiatrist inspects the patient's foot and watches them sit and stand to see how the arch looks in both positions. Typically, the podiatrist will take x-rays of the foot to establish how severe the flatfoot is and if it is in the early or later stages. Some patients diagnosed with the condition don't even have any symptoms. If this is true in your case, your podiatrist should explain to you what you can expect with the disorder.
Symptoms may include:
- Experiencing pain in the heel, arch, ankle, or along the outside of the foot
- An ankle that appears to be "turned in".
- Shin splints
- A feeling of weakness or fatigue in the foot or leg
What are the Treatment Options for Flatfoot?
Your podiatrist may advise one or more of the folllowing treatment options:
- Modify or restrict activities which cause pain and try not walk or stand for long periods of time. You need to rest your arches and take some of the strain off of them.
- Weight loss. Carrying a lot of weight puts strain on your arches and may aggravate the deformity.
- Custom orthotics. Support for your arches is important. Your podiatrist may recommend custom orthotics to give you that support.
- You may need to keep your foot immobilized for a time and may even need to utilize a walking cast.
- Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be prescribed to help reduce pain and inflammation.
- Ultrasound therapy or other methods of physical therapy may be necessary.
- You should always wear shoes with good arch support. The Best Shoe Selection video above will help to determine the right shoe for your foot.
When is surgery for flatfoot needed?
When pain caused by flatfoot is not relieved sufficiently by more conservative treatments, surgery may be recommended. Several different surgical techniques are offered to fix flexible flatfoot deformities. Depending on your case, you may need one procedure or a combination of procedures. The goal of all the procedures is to relieve pain and the symptoms of flatfoot and improve the function of the foot. The procedures needed may include: tendon transfers or tendon lengthening procedures, realignment of one or more bones, joint fusions, or insertion of implant devices. The procedure chosen for your particular case will depend on many different factors.