Symptoms of Flat Foot
Flat foot is a very common condition in both children and adults. Flexible flat feet are considered to be a normal variation of the foot, but rigid flat feet may require treatment. Symptoms of flat feet include pain along the inside of the foot, swollen ankles, pain that worsens with physical activity, and pain on the outside of the ankle. Flat feet can be caused by damage to the posterior tibial tendon (which starts at the calf and attaches to the bones inside the foot), arthritis, an injury to the ligaments or bones in the foot, or diabetic collapse/Charcot foot.
Flat Feet in Children
Children are often born with very little arch in the feet, so flat feet often correct themselves without treatment as the child gets older. Typically, children have “flexible flat foot” that causes the feet to be flat when the child is standing, but the arches to appear when the child stands on tiptoe. Flexible flat foot is considered to be normal, especially in children, and rarely presents complications or affects participation in sports. If by adolescence the child still has not developed an arch and begins to experience pains along the bottom of the foot, book an appointment with a doctor.
Diagnosing and Treating Flat Feet in Adults
Flexible flat feet are typically treated without surgery. We will perform an examination including checking wear patterns on everyday shoes and asking you to perform basic tasks such as sitting, standing, raising the toes while standing, and standing on tiptoe. We will also examine the Achilles tendon to ensure there is no abnormal tightness, and check your feet for calluses. To treat flexible flat feet, we may prescribe simple exercises and stretches, shoe inserts, or physical therapy. In rare cases, flexible flat feet may develop into rigid flat feet and will need further treatment such as more intense physical therapy or even surgery.
Adult Acquired Flatfoot
There is usually a problem when only 1 of your feet starts to flatten and the deformity progresses. This is called an adult acquired flat foot and is usually due to a problem with the posterior tibial tendon. Symptoms are usually pain on the medial or inside part of your foot and ankle and there is a gradual and progressive flattening of the arch of your foot. This condition often requires surgery and may progress from being flexible to a rigid deformity if not treated. Surgery may require tendon transfers, the realignment of bones or fusion of the joints. It is best to see an orthopedic surgeon if you have noticed a change in the shape or alignment of your foot, especially if you have pain.
Treating High Arches
High arches, also known as Cavus Foot, can cause pain and instability in the foot as a result of excess weight being placed on the ball and heel of the foot. Those with high arches may also be more prone to hammertoes, claw toes, calluses on the ball, side, or heel of the foot, and ankle sprains. It can be caused by a neurologic disorder or simply a structural abnormality. If the cause is a neurological disorder, the condition is likely to worsen if left untreated but if the cause is structural, it will usually not get any worse. To diagnose high arches, we begin with a family history and an examination, followed by muscle strength tests, an analysis of walking patterns, examination of shoes, and sometimes X-rays. If the cause is neurological, you may be referred to a neurologist but if it is simply structural, treatment will usually begin with orthotic devices, shoe modifications, and bracing. If conservative treatment fails to produce results, surgery may be an option to decrease pain and improve stability.
