Flat Feet
Have you ever looked at the shape your wet foot leaves on a surface? If you can see your entire footprint, you most likely have a flat foot.
Flat feet occur in all shapes and sizes. Flat feet can become painful, can occur in childhood or develop later in life. Flexible flat feet may appear as though you have arches when sitting, but collapse when standing due to a tendon insufficiency. What may start as a flexible foot can then develop into a very firm, rigid deformity over time. The shape of the flat foot can change as the foot may start to point outward allowing for the entire sole of the foot to fall and touch the floor as the deformity progresses.
Many times people have minimal symptoms associated with flat feet. Those who have pain typically notice pain to the inside portion of the foot and ankle especially after standing or walking for long periods of time. Swelling may also be noted in this area. As the flatfoot becomes worse the pain may travel to the outside portion of the foot and ankle.
Schedule an appointment today with Dr. Bryant Castelein, DPM – Podiatry Specialist
Causes of Flat Feet
Some people are genetically susceptible to flat feet, while other people begin with normal arched feet that gradually flatten over time. This is referred to as acquired fallen arches.
An acquired flatfoot can occur from:
- Genetics or family history
- Injury
- Obesity
- Aging
If left untreated, flat feet can lead to a variety of conditions, such as plantar fasciitis, heel spurs, bunions, hammertoes, early arthritis, neuromas, and ankle sprains.
If you or your child feel pain and are suspicious of flat feet, deformity, or you notice an inability for your child to keep up with their peers, it is best to visit Dr. Castelein for treatment to avoid further complications.
Diagnosing Flat Feet
Multiple different diagnostic measures and tools are used to confirm flat feet, typically done in the following order:
- Range of Motion Testing and Tendon Strength and Mechanics: First, Dr. Castelein will perform a clinical exam to test ankle flexibility and check range of motion to assess the strength and mechanics of the posterior tibial tendon along with other tendons and ligaments of the foot.
- X-Ray: At Brighton Foot and Ankle, we utilize in-office X-rays for a quick and painless experience. X-rays are useful when determining the severity of flat feet. Dr. Castelein will review the X-ray for bone and joint position to diagnose the prevalence of flat feet.
- MRI: In some cases, an MRI is necessary to further evaluate the tendon and ligament structures of the feet to diagnose the degree and stage of flat foot. MRI’s are especially helpful to understand the full picture of the flatfoot and during surgical planning.
If your flat feet are causing you pain, Dr. Castelein may suggest orthotic devices, physical therapy,or at-home stretching exercises.
- Ankle and Foot Orthotics: Orthotics can reduce the pain associated with flat feet and work best when paired with a supportive shoe. Orthotics help keep your foot in its neutral position to allow the best mechanical pull of the tendons. They support the bone and ligament structures helping to reduce the onset of arthritis as well.
- Physical Therapy: A physical therapist can help reduce pain and discomfort, suggest lifestyle changes, and prescribe targeted stretches and special exercises specific to flat feet. Physical therapy is an excellent tool to reduce inflammation, swelling, tendonitis, training in proper gait, and walking mechanics.
- Stretching Exercises: At-home stretching exercises, such as calf raises, towel curls, etc., may be prescribed to stretch the Achilles tendon and reduce pressure on the flat foot.
- Anti-Inflammatory Medications: In some cases Dr. Castelein may prescribe medications to reduce inflammation in the area.
Surgery may be necessary when patients experience continued pain following conservative treatments. Dr. Castelein’s ultimate goal of flat feet surgery is to restore proper bone and joint alignment to allow for proper mechanical pulling of the tendons reducing pain to the foot and ankle. There are two main types of flatfoot surgeries he uses, joint-sparing and joint fusion.
- Joint-Sparing Reconstruction: Surgical procedures focusing on adjusting the shape and position of joints are called joint-sparing. They seek to realign the mechanics of joints and tendons to reduce pain and deformity. These procedures are used to address the posterior tibial tendon and flat arch in pediatric or early stages of flat foot. The arch of the foot is recreated surgically by combining soft tissue and bony techniques into the surgery. Patients benefit from this surgery with pain relief and preserving the natural function, motion, and appearance of the foot. The full recovery period varies but may involve six to eight weeks of non-weight bearing protection. After the recovery period patients can expect a return to high activity and normal lifestyle.
- Joint Fusion: This surgical method is typically used when the flat foot is rigid and accompanied by a large amount of arthritis. This is normally found in geriatric patients or very advanced stages of flat foot. By fusing the joints in the back of the foot and removing any arthritis present, Dr. Castelein can realign the foot to its normal shape. Removing the damaged and painful joints allows for better motion with the remaining bones and joints. This surgery usually involves a six to eight week period of non-weight bearing protection. Patients needing a joint fusion procedure can expect to return to a normal lifestyle and activity.
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