Flat Feet

Pes Plano valgus or “flatfoot” is a common condition that affects many people of all ages. It is often used to describe a foot with a flattened or lowered arch. Patients may complain of walking on the inside of their ankles and have a heel that appears to be rolled-out from under the ankle.  Often times, people will complain of pain to the arch of the foot after standing for long periods of time either at work or during physical activity.

Infants feet are naturally flat and as they grow and begin to walk, their feet normally develop arches. Most children don’t fully form an arch until age 3-5. For some children, this does not happen, and they may begin to complain of sports-related knee, leg, heel, ankle or arch pain. It is also possible for patients with pes Plano valgus to develop bunions. While pes Plano valgus is usually inherited, there are many individuals who have normal arches as children and young adults but develop flat feet over time. These individuals are said to have an adult acquired flat foot deformity (AAFFD).

Risk Factors for Flat Feet

Heredity is a major cause for people with flat feet. Other risk factors include wear and tear due to aging or obesity, rheumatoid arthritis, traumatic injuries, and dysfunctions of tendons or ligaments.

Symptoms

Pes Plano valgus is not always symptomatic (painful). However, flatfeet are often associated with the feeling of tired and achy feet. Patients may experience pain on the instep of their foot and/or along the inside of their ankle.

When the condition of an individual with flat feet deteriorates, the person may suffer from pain not only in the foot or ankle, but in the knee, or back. It is also common for such people to develop bunions and other deformities of the lower extremity. In such cases, surgical intervention may become necessary.

Diagnosis

While flat feet are diagnosable through simple physical examination, diagnostic imaging is usually needed. This includes:

  • X-rays
  • MRI
  • CT scan
  • Ultrasound

These tests are often necessary to determine the extent of deformity and which treatment option is best for you.

Treatment

We will almost always begin with conservative treatment in a patient with pes Plano valgus. This includes properly educating the patient on what types of shoe gear to wear and to avoid walking barefooted. Orthotics are a key component in the first-line treatment of pes Plano valgus.  These are placed into both shoes to provide extra arch support.  Keep in mind that foot orthoses should not be expected to create a permanent structural correction of the foot, but rather eliminate symptoms and improve the patient’s activity level. Other conservative measures can be implemented but can vary with each patients’ specific circumstances.

When conservative measures have failed and the patient is unable to perform their daily activities secondary to pain, then surgical intervention is usually necessary. Surgery for flatfoot may involve cutting of bones and/or fusing one or more of the bones in the foot together. Our goal is to provide the patient with a more active pain-free lifestyle.

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