Flexible Flatfoot

Flatfoot is a common disorder experienced by many people, and it can be quite complex with diverse symptoms, various degrees of deformity, and different levels of disability. The common characteristic shared by all types of flatfoot is the loss or partial collapse of the arch. Other shared features of most types of flatfoot include “toe drift,” where the toes and front part of the foot point outward, heel tilting towards the outside, and the ankle appearing to turn inward.

Flexible flatfoot is one of the most prevalent forms of flatfoot, and it typically starts during childhood and extends into adulthood. It affects both feet and progresses in severity throughout the adult years. Even though the foot is flat when standing, the arch returns when it’s not standing. However, as the deformity worsens, the soft tissues such as tendons and ligaments of the arch may stretch or tear, which can cause inflammation.

The symptoms of flexible flatfoot can vary from individual to individual. Some may experience pain in the arch, ankle, heel, or along the outside of the foot. Others may have a “rolled-in” ankle or over-pronation, shin splint, general fatigue, or aching in the foot or leg, and some may even experience low back, hip, or knee pain.

If you suspect that you may have flexible flatfoot, it’s essential to get a diagnosis from a foot and ankle surgeon. They will examine your foot and observe how it looks when you stand and sit. Additionally, they may take x-rays to determine the severity of the disorder. If the surgeon diagnoses you with flexible flatfoot but you don’t have any symptoms, they’ll explain what you can expect in the future.

Non-surgical treatment options recommended by the surgeon usually depend on your symptoms. They may suggest activity modifications and advise you to cut down on activities that bring you pain and avoid prolonged standing and walking to let your arches rest. If you’re overweight, the surgeon may recommend losing weight because putting too much weight on your arches may aggravate the symptoms. Orthotic devices are custom-made for your shoes to give more support to the arches. In some cases, immobilization may be necessary, usually with a walking cast, or you may have to completely avoid weight-bearing. Medications such as nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen can help reduce pain and inflammation. Physical therapy may be an option, and ultrasound therapy or other physical therapy modalities may provide temporary relief. Wearing shoes that support your arches is crucial for anyone with flatfoot.

If your symptoms do not improve with non-surgical treatments, the foot and ankle surgeon may consider surgery. A range of surgical techniques is available to correct flexible flatfoot, and a combination of procedures may be required to relieve symptoms and improve foot function. The surgeon will take into account the extent of the deformity based on x-ray findings, your age, activity level, and other factors when deciding on the surgical method or combination. The recovery period duration will vary and depend on the procedure or procedures performed.

In summary, flexible flatfoot is a common type of flatfoot that mostly affects individuals from childhood into adulthood. Symptoms are usually mild but can worsen over time, causing severe pain and disability. Non-surgical treatments are often the first line of approach and can provide relief to most individuals. If symptoms persist or worsen, surgery may be necessary. Dr Gilbert Huang DPM is a reliable foot and ankle surgeon who can assist in the diagnosis and treatment of flatfoot-related disorders.

Pediatric Flatfoot