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For Patients Suffering Flatfoot: Do Not Wait to Seek Help

Early diagnosis and treatment can lead to improved outcomes.  

Early diagnosis and treatment for adults suffering from a painful fallen foot arch, or adult-acquired flatfoot, is key to increase improved long-term outcomes, reduce the likelihood of more severe foot deformities and lessen the need for surgical intervention.

While flatfoot is a very common foot condition, foot and ankle surgeons say it is a complex disorder with varying degrees of deformity and disability. "Most all types of flatfoot have one characteristic in common: partial or total loss of the arch, which means the upward curve in the middle of the foot is virtually gone," says Kris DiNucci, DPM, FACFAS, a Scottsdale foot and ankle surgeon and Fellow Member of ACFAS.  

Adults suffering from flatfoot might see a progressive deformity that commonly results from a stretched or torn posterior tibial tendon (the tendon that goes behind the inside of your ankle and attaches in the middle of your foot, helping to create your arch). This tendon can become stretched out over time, leading to strain on the inside of the foot and ankle and resulting in a flatfoot deformity that can cause pain and make the foot appear to be flat on the bottom.

According to Dr. DiNucci, patients with flatfoot deformity often experience pain, redness and swelling on the bottom of the foot, especially near where the arch should be, and find that feet movement (such as standing on toes) is difficult or impossible. Patients might also experience back and/or leg pain associated with the loss of the arch.

Feet that suffer from flatfoot generally fall into two categories: flexible or rigid. Flexible flatfoot is a normal arch when nonweightbearing, or sitting, with disappearance of the arch when standing. The flexible flatfoot may or may not cause tenderness. In the case of rigid flatfoot, the arch is stiff and flat when both sitting and standing. In either case, there are a variety of underlying causes, requiring different treatments.

"The earlier a patient is diagnosed, the more likely they are to be able to benefit from conservative, nonsurgical methods to fix the problem," Dr. DiNucci says. The longer a patient has suffered the effects of flatfoot, the more likely they are to need surgery.

According to DiNucci, foot and ankle surgeons first try less invasive, more conservative measures to solve the problem, including decreased activity, physical therapy, shoe inserts (orthotics), immobilization, anti-inflammatory drugs and weight loss. If nonsurgical treatments fail to help symptoms and deformities persist or worsen, more extensive treatments, including surgery, may be required.