Adult flatfoot is a condition that causes flattening of the arch of the foot. This condition is usually inherited or caused by an injury. In other cases, it may also be caused by rheumatoid arthritis, stroke, excessive weight or diabetes.
Treatment for flat feet and fallen arches depends on the severity and cause of the problem.
Progressive Flatfoot (Posterior Tibial Tendon Dysfunction)
If this tendon becomes inflamed, overstretched, or torn, you may experience pain on the inner ankle and gradually lose the inner arch on the bottom of your foot, leading to flatfoot.
A trial of non-operative treatment should be completed prior to any decision to have surgery.
This treatment includes:
If these are unsuccessful, surgery can be considered.
Flatfoot frequently causes pain in your ankles and difficulty with daily activities. Doctors perform surgical flatfoot reconstruction if you have an arch collapse that is still flexible (not stiff). Your doctor will do a complete evaluation of the foot. This includes your medical history, physical exam, and X-rays.
A number of surgical procedures can be used to reconstruct a flatfoot. These procedures are separated into those that correct deformities of your bones and those that repair your ligaments and tendons. Your doctor will choose the proper combination of procedures for your foot. Surgery can be performed under regional anesthesia, which is numbing your foot and ankle with a nerve or spinal block, or general anesthesia, which may require a breathing tube. A nerve block is often placed behind the knee to reduce pain after surgery.
You may go home the day of surgery or your doctor might suggest an overnight hospital stay. Your leg will be placed in a splint or cast and should be kept elevated for the first two weeks. At that point, sutures are removed. A new cast or a removable boot is then placed. It is important that you do not put any weight on the corrected foot for six to eight weeks following the operation. You may begin bearing weight at eight weeks and usually progress to full weight-bearing by 10 to 12 weeks. After 12 weeks, you can transition to wearing a shoe. Inserts and ankle braces are often used. Your doctor might also recommend physical therapy.