Flatfoot: A Condition that Affects Your Steps


Flatfoot, also known as pes planus, is a condition that affects the arch of the foot, causing it to collapse and come in contact with the ground. 

This can result in a loss of the normal arch shape of the foot and can lead to a variety of symptoms, including pain and difficulty with walking. Flatfoot can impact people of all ages, and there are several types and causes of the condition.

What Causes Flatfoot? 

One of the most common causes of flatfoot is a condition called Posterior Tibial Tendon Dysfunction (PTTD). PTTD occurs when the tendon that runs along the inside of the ankle and foot becomes damaged or torn, resulting in a loss of support for the arch of the foot. This can lead to the arch collapsing and the foot becoming flat. PTTD is often seen in middle-aged individuals, and it can occur as a result of a variety of factors, including arthritis, obesity, and overuse injuries.

Another common cause of flatfoot is a congenital condition called congenital vertical talus. This condition is present at birth and occurs when the bones in the foot are malformed. As a result, the arch does not develop properly, leading to a flatfoot. This condition is relatively rare, but it can be associated with other problems such as club foot or spina bifida.

Flatfoot can also occur as a result of other underlying medical conditions such as diabetes, rheumatoid arthritis, and other inflammatory conditions. Furthermore, certain medications and treatments such as corticosteroids can also cause flatfoot.

How Is Flatfoot Diagnosed?

Diagnosis of flatfoot typically begins with a physical examination by a healthcare provider. The provider will examine the shape of your feet and the way that you walk, looking for signs of an unstable arch. They may also use imaging tests, such as x-rays, to get a better look at the structure of your feet. In some cases, your provider may also recommend a CT scan or MRI to help make a diagnosis.

The most common symptoms of flatfoot are pain and difficulty walking. Pain can be felt in the heel, arch, ankle, or along the inside of the foot and ankle. The pain may worsen with activity and may improve with rest. You may also experience stiffness or weakness in the foot and ankle, or notice a change in the shape of your foot and ankle.

Managing Pain From Flatfoot

Pain management for flatfoot can include a variety of different approaches. In many cases, over-the-counter pain medications, such as ibuprofen or acetaminophen, can be effective in reducing pain and inflammation. Additionally, your healthcare provider may recommend that you rest your feet and avoid activities that are likely to aggravate your condition. They might also suggest custom orthotics, which can help support the arch of the foot and reduce pain.

Physical therapy is also a valuable tool in managing the pain associated with flatfoot. It can help to strengthen the muscles in your feet and ankles, as well as improve your balance and flexibility. This can help to reduce your risk of falls and injuries, as well as improve your overall quality of life.

Treating Flatfoot

Treatment for flatfoot can vary depending on the underlying cause of the condition and the severity of the symptoms. In many cases, non-surgical treatment options, such as wearing supportive shoes or inserts, physical therapy, and exercises to help strengthen the muscles in your feet, can be effective in managing the condition. These approaches are usually recommended for mild to moderate cases of flatfoot.

If non-surgical treatment options are not effective or if the condition is severe, your healthcare provider may recommend surgical options. These can include procedures to reposition the bones of the foot, such as procedures to realign the heel bone, as well as procedures to fuse bones together to help stabilize the arch. Surgery is typically recommended for more severe cases of flatfoot that do not respond to non-surgical treatment.

One of the most common surgical procedures for flatfoot is called hindfoot fusion. This procedure is used to fuse the heel bone with the ankle bone in order to improve the alignment of the foot and reduce pain. Another common surgical procedure is a triple arthrodesis. This procedure involves fusing together three bones in the foot: the heel bone, the ankle bone, and the hindfoot bone, which will improve the alignment of the foot and reduce pain.

In addition to surgical procedures, there are a number of other treatment options available to patients with flatfoot. These include:

  • Bracing: A variety of different braces can be used to support the arch of the foot and help prevent the arch from collapsing.
  • Casts: Some patients with flatfoot may be placed in a cast or walking boot to help protect the foot and keep it immobilized during the healing process.
  • Custom orthotics: These are special inserts that are designed to fit inside your shoes and provide support for the arch of the foot.
  • Stretching and strengthening exercises: These exercises can help to improve the strength and flexibility of the muscles in your feet and legs, which can help to reduce the risk of falls and injuries.

Flatfoot can be a debilitating condition that can greatly impact the quality of life of those who have it. It’s important to work with your healthcare provider to develop an appropriate treatment plan that addresses your specific needs. With the right treatment and management, most people with flatfoot are able to reduce their symptoms and improve their mobility and overall quality of life.

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