Flatfoot in Adults – What Are Your Options?

Your options for adult flatfoot!

During my time in Chicago, I had the honor of working with some of the finest foot and ankle surgeons in the country and I took advantage of all of their precious knowledge. One particular area of expertise that I have extensive experience in is the adult and pediatric flatfoot. When I see a flatfoot I am able to identify the proper course of action almost immediately following my examination. When you have a full knowledge of a certain condition the doctor should be able to tell you what your journey to achieve healing will be. I inform my patients of their condition in a complete and concise manner so that they too have an understanding of why and how we develop our treatment plans. I feel this prepares the patient mentally for the journey ahead so that their expectations are realistic and grounded. In this blog I am going to cover the topic of flatfoot. Why it happens and how do we fix it?

Flatfoot or pes planus is a very common pathology that can affect both the pediatric and adult populations. Many people complain of having a painful arch when walking and that sometimes they have pain all over their foot. For some the pain is unbearable and that just walking causes them extreme pain. Children often complain of tripping over their feet and feeling fatigued when playing sports. The reason for the variety of symptoms is because every flatfoot has unique characteristics. Some patients have a heel that is everted, others have a bulging bone on the inside of their foot, and sometimes some people have decreased arches and also are knock kneed. The reason for all these different variations is because the structure of the flatfoot involves a combination of joints, tendons, and ligaments. This is why it is very important for the physician to perform a comprehensive examination of the structure/function of the foot. We do this by attaining radiographs, performing a thorough physical exam, and also performing a gait analysis. By doing these three things the doctor can determine what the main cause of your flat foot is. Once we determine the root cause then we can effectively treat your symptoms.

So why does this happen to us? In its simplest explanation a flatfoot occurs because you are either born with it or the structures that hold your arch up can no longer perform their job. Congenital flatfoot or pediatric flatfoot is typically due to your genes. Sometimes we are born with loose ligaments and weak tendons. This combination is a recipe for a severe flatfoot. On the flip side, adult flatfoot is typically caused by overuse. As we age, body weight becomes a factor as well as increased activity. We make our tendons and ligaments weak by over stretching them until they are unable to effectively perform their duty. This leads to fatigue and pain even when performing simple activities such as walking. The etiology of this condition is much more in depth but for the sake of this article we will keep it short.

The treatment of flatfoot is also very diversified and is typically limited by the experience of the physician. Since we at Advanced Podiatry have had extensive training with this condition I am able to offer you a wide array of options. My treatment protocol is as follows. Initially I try to treat everything conservatively, which means I will try to find the simplest solution to help alleviate your symptoms. The starting point is to have you invest in a pair of custom orthotics.  As I mentioned above the root cause of a flatfoot could be due to overuse of the bodies’ tendons and thus causing an inhibition of function for that tendon. The orthotic acts as a scaffold to hold up the arch so that the tendon/ligaments have less work to perform, thus are not being over strained. The custom orthotic is a very powerful treatment in the quest to abolish flat foot symptoms and is almost always my first suggestion for the patient. Next tool would be physical therapy. We work with an excellent physical therapy team in order to provide fast recovery with tailored treatment modalities to have the patient return to their regular activity quickly. Pain is a main complaint so we also use a combination of therapies such as our Super pulse laser which can effectively reduce edema and decrease pain almost immediately after one treatment. We apply the super pulse laser to areas of tenderness and within 5 minutes we can improve symptoms. The physical therapy team also has modalities which they use in order to help improve symptoms. The primary role of the physical therapist is to strengthen what is weak and help heal the pathology with stretching and range of motion exercises. With this combination of therapies we are able to effectively treat your flatfoot pain.

When conservative therapy fails only then do we consider more invasive techniques. At Advanced Podiatry we pride ourselves in being at the cutting edge of podiatric medicine and surgery and therefore we are well versed in both traditional and regenerative methods of treating your symptoms. Some of our treatment methods include, prolotherapy, prolozone, shockwave, platelet rich plasma, and stem cell therapy. The use of these treatment methods are specific and therefore can only be used by specific patients for specific conditions. Your doctor will assess your needs and offer these choices if they are applicable to your symptoms. We do not haphazardly try different methods in hopes of relieving your pain but we do consciously choose each treatment method with purpose. This guarantees both effective and efficient treatment for the patient.

Surgical correction for a flatfoot is something that is not taken lightly. The patient unfortunately at this point has had minimal relief with conservative measures and is unable to perform their daily activities of life. When the patient meets those two criteria I will consider surgical therapy. The doctor will confirm the “planal dominance” of the foot which means he will find the main deformity of the foot and determine from that starting point how he will proceed with correction of the foot. This process is a very methodical way of approaching correction of a flatfoot with surgical intervention. With this method the doctor will be able to provide a proper plan to correct the structure of the foot. The patient must also realize that their recovery will be somewhat long and difficult. This is why we as doctors will take their time to explain the entire procedure and also answer all your questions to your satisfaction.

Flatfoot problems are very common and are easily treated with conservative measures. As I stated above we at Advanced Podiatry are highly trained in effectively treating flatfoot symptoms with both conservative and surgical methods. We exhaust all conservative treatments, both natural and traditional, before we consider any type of invasive procedures. Alleviating symptoms and correcting the problem is the primary goal and fortunately our training allows us to offer a wide array of treatment options that can be tailored to the comfort level of the patient. Please stop in today to talk with highly skilled doctors.

Best Regards,

Dr. Jairo Cruz Jr