In practice many patients present with flatfoot deformities. Flat feet come in all shapes and sizes, but they generally look the same. The condition is readily seen at the swimming pool when you get out of the water you can see your arch and whether you have one. There are partial flat foot deformities as well as total flat foot deformities. Total would look like a complete collapse of the arch.
Patients don’t necessarily have to be painful and with those I have a hands-off approach. When symptoms occur, patients benefit from treatment. Symptoms come in all shapes and sizes but mainly would be fatigue, foot and ankle pain, knee or hip pain and possibly back pain. Remember that the ankle bone is connected to the leg bone. Commonly we will observe outward tilting of the toes, shoe difficulty, and reduced energy to name a few. Flat foot can be present from birth or arise later in life. Flat feet can be in both feet and in only a single limb.
Flat foot deformity divides into two camps, rigid and flexible. Conditions like Tarsal Coalition and Vertical Talus cause flat feet. Without getting technical these conditions are bony ones that do not allow for free movement of the feet. Rigidity is most notable in the hindfoot with these conditions.
Flexible flat feet have multiple causes, but the good news is that they are flexible. The most common presentation is a pediatric flexible flat foot that is not corrected in any way. Patients will note that they may have had in-toeing as a child. There are some flat foot deformities that are as a result of tendon injury that are usually one sided. Tendonitis namely on the inside of the ankle can be the cause of the one-sided condition.
Diagnosis is made clinically in the office. Range of motion exams, gait and stance exams help to make the diagnosis. Radiographs can be taken to diagnose the condition.
Most cases are addressed non-surgically. Orthotic management is used to help to support the arches which are usually successful. Think of orthotics as eyeglasses for your feet. That analogy is appropriate here. Physical therapy as well as NSAIDs can be used but are usually not first line therapy.
Some cases go on to surgery but that is highly unlikely and reserved for the most severe of cases. Some surgeries are soft tissue procedures while some need bone surgery. I prefer conservative care as a wise man famously said, “Minor surgery is performed on someone else, not me”.
To find out more about pediatric flatfoot or other foot and ankle problems, please call us at (609) 561-2488 or complete the consultation request form.
David Weiss, DPM, is the owner of Weiss Foot & Ankle Center located at 777 South White Horse Pike, Suite D1 in Hammonton. For more information or to make an appointment, call 561-2488 or visit weissfootandankle.com.