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Flat Feet Treatment in Brighton, MI

Flat feet, also called fallen arches, occur when the arch of the foot collapses and the entire sole makes contact with the ground. Some people are born with flat feet while others develop them over time from injury, aging, or tendon weakness. Flat feet can cause pain in the feet, ankles, knees, hips, and even the lower back — and left untreated they can lead to more serious conditions including plantar fasciitis, bunions, hammertoes, and arthritis. At Brighton Foot & Ankle, Dr. Castelein diagnoses and treats flat feet in Brighton, MI with a personalized approach focused on relieving pain and preventing further complications.

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1-810-227-3864

Causes

Flat feet can be genetic or acquired. Common causes of acquired flat feet include:

An acquired flatfoot can occur from:

  • Genetics or family history
  • Injury
  • Obesity
  • Aging

If left untreated, flat feet can lead to a range of secondary conditions including plantar fasciitis, heel spurs, bunions, hammertoes, early arthritis, neuromas, and ankle sprains. Early treatment — especially in children — can prevent many of these complications from developing.

Posterior Tibial Tendon Dysfunction (PTTD)

The most common cause of adult acquired flatfoot is posterior tibial tendon dysfunction, or PTTD. The posterior tibial tendon runs along the inside of the ankle and is responsible for supporting the arch and inverting the foot. When this tendon becomes inflamed, stretched, or torn from repetitive stress, the arch gradually collapses. PTTD progresses in stages:

  • Stage 2 — the tendon is weakened and the foot shows a flexible flatfoot deformity. Patients are unable to complete a single heel raise on the affected foot and may notice the front of the foot pointing outward. Conservative care including orthotics, bracing, and physical therapy is the first line of treatment. Surgical options include tendon repair and bone realignment procedures.
  • Stage 3 — the deformity becomes more rigid and arthritis begins to develop in the rearfoot joints. Surgical intervention is more common at this stage and may include tendon reconstruction combined with joint fusion procedures.
  • Stage 4 — end stage PTTD with severe arch collapse and talar tilt. A double or triple arthrodesis of the rearfoot is typically performed to restore a stable, braceable foot structure.

Diagnosing Flat Feet

Diagnosis typically involves the following steps in order:

  1. 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.
  2. 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.
  3. 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.

Conservative Treatment

When flat feet are causing pain, Dr. Castelein starts with conservative options before considering surgery:

  • 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.

For children with flat feet, Dr. Castelein monitors development every six to twelve months. Custom or over the counter orthotics can help guide proper alignment as the foot grows. Most children with flexible flat feet do not require surgery, but early intervention can prevent pain and complications from developing later in life.

Surgical Treatment

When conservative treatment hasn’t provided enough relief, surgery may be needed to restore proper bone and joint alignment and reduce pain. Dr. Castelein uses two main approaches depending on the stage and severity of the flat foot:

  • 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.

Foot or Ankle Pain From Flat Feet?

Flat feet are very treatable when addressed early. Don’t wait until the pain spreads to your knees or hips. Book online or call us today for an evaluation in Brighton, MI.

Schedule Online
1-810-227-3864

What Our Clients Think

Client Testimonials

Julie
I'm so happy to have found Brighton Foot And Ankle in Brighton. The office staff and assistant are very pleasant. Dr. Bryant Castelein is a great knowledgeable Dr. Who has eased my worry over my medical condition. Plus he's handsome. I would highly recommend this practice for anyone needing podiatry help.
Amy
What great people to help you! From receptionist to doctor, they are top notch! You would not regret going here for any of your foot/ankle problems, they will fix you up with the utmost care and compassion.
Yo K
Dr. Castelein and staff were friendly, knowledgeable , efficient and took the time to get to know me and understand my medical needs. I would not hesitate to go to Brighton Foot & Ankle. They go out of their way to treat their patients like family.
Robert
Dr. Castelein is great; he is very nice, patient, and professional. His staff is also excellent and friendly. It's only been about three hours since having my big toenail removed and, with acetaminophen and ibuprofen, there is very little pain(sometimes I completely forget about it); he did an excellent job. Overall, I am very impressed with Dr. Casteleins Practice and I would highly recommend his office.
Joseph
Doctor & staff were so professional, friendly & efficient. I had a high risk condition that they expertly guided me through 5 months of healing. Thankfully a full recovery. I give them my best recommendation.
Lexi
Very friendly and accommodating front desk staff. Dr. Castelein and Jennifer always take their time and do an amazing job! Great variety of quick pick up over the counter products that are always affordable too. Best experience I have had at an office.
Christena
Dr. Castelein is very friendly and extremely knowledgeable in his field. During my visit he did a great job explaining my situation and was very encouraging of any questions. I never felt rushed and I believe to have received the best care possible. Highly recommend this doctor and this facility.
Nicole C
Excellent staff and exceptional doctor. I went in with Bunion issues. Dr. Castelein listened to my concerns and addressed my options. 4 days post-op bunion surgery I can say he did an amazing job. Best experience I have ever had. I would definitely recommend; I promise you won't look further.
Ashley
The staff and Dr. Castelein are all amazing. They are polite and very respectful. I came to see them in 2019 for bunion and hammer toe issues among some others. Dr. Castelein and his assistant listened to my concerns and gave me my options. He explained everything to me in detail and all my questions were answered.. I have seen other podiatrists and he is beyond the best. I would recommend him to anyone.
Alex
Friendly staff and intelligent doctor! I went in for some ankle X-rays and was given a great strategy on the different ways to heal my ankle, and how to progress forward if less invasive treatment doesn't help. I would highly recommend them to anyone with foot or ankle problems!