Flat feet


On a day to day bases we hear people complain that they have flatfeet, but what exactly is flatfeet, what is the cause and how is it treated? A flatfoot, medically known as pes planus, is when the arch of the foot collapses. The biomechanical cause is when the subtalar joint, the joint below the ankle joint, is out of its’ correct alignment.

At what age can flatfeet begin to develop?

Many parents are concerned when they see their toddlers beginning to walk because it may appear to them that their toddler walks flatfooted. The fact is that before the age of five there is an increase of fatty tissue to the foot, and in addition, it takes up until that age for all the bones in the foot to be developed. Therefore, parents shouldn’t be concerned about flatfeet until around age five. There is a difference between in toeing and flatfeet and if one is concerned they should be evaluated by a physician.

How can one treat their young children and adolescents who suffer from flatfeet?

As children begin to increase their physical activity and play more sports parents may begin to notice that a flatfoot is developing. Around this time children playing sports may begin to complain of foot pain while doing their activities. Many times, during this age a flatfoot develops and if treated early enough one can prevent it from worsening, which will ultimately prevent problems later in life. Conservatively it can be treated with orthotics, which are devices worn in the shoes to lift the arch and give more arch and heel support. If parents are interested in a more permanent fix there is a surgical procedure where an implant called an arthroereisis is place in the foot. The implant is placed in the subtalar joint, which is the joint directly beneath the ankle joint. The function of the implant is to correct the flatfoot deformity at the crux of the problem. The implant acts as an “internal orthotic”. The surgery is performed as a same day procedure, with a 4 week recovery time. Children and young adults tolerate the procedure well and are ultimately fixing the cause of the flatfeet.

What about adults that develop flatfeet?

Many people don’t develop flatfeet until later in life. When adults begin to develop this problem, it is usually due to different reasons than for children. Adult acquired flatfoot can be caused by illness, overuse, tendon injury etc. With an adult flatfoot, it is more noticeable when one is non-weight bearing. The symptoms of an adult flatfoot may be different than with children and may only cause discomfort sporadically. Adult flatfoot is treated per the symptoms. Many of these patients suffer from tendon pain in the arch area, which can be treated with orthotics, supportive braces, anti-inflammatory and physical therapy.
No matter what the age or cause of flatfeet there are many different treatment options for all different ages.