Flatfoot Specialist in Phoenix, Scottsdale, AZ
Flatfoot is a deformity where the arch of the foot collapses sometimes resulting in pain in the foot and difficulty with walking/running. The condition is present in all age groups. Damien Richardson MD, MPH provides expert diagnosis and individualized non-operative and operative treatments for a painful flatfoot deformity in Phoenix, Scottsdale, AZ. Contact Dr. Richardson’s team for an appointment today!
What is Flatfoot?
A flatfoot is normal in the first few years of life as the arch of the foot usually develops between the age of 3 and 5 years. Many people live with a flatfoot there entire life and it does not bother them so there is typically nothing to about it. However, on occasion someone may develop a flatfoot on one side where they didn’t have one before. When this happens the arch that runs along the sole of the foot begins to collapse towards the ground and it appears like the foot and ankle may be rolling inward. People have often heard the term “pronation” to describe this position of the foot. This collapse of the arch is often associated with pain and weakness during running or strenuous exercise. From a medical and orthopaedic perspective once a flatfoot becomes symptomatic and/or begins to progress with further deformity it may be diagnosed or called different things: posterior tibial tendon dysfunction (PTTD), adult acquired flat foot disease (ACFD), and progressive collapsing flat foot deformity (PCFD). When a flatfoot becomes painful is typically when it is time to seek care.
What are the Types of Flatfoot?
There are many types of flatfeet! The arch can breakdown at many places along the foot. Remember there are 26 bones and 33 joints in the foot! A flatfoot typically can be classified as rigid or flexible. Depending on what structures are involved in the loss of arch height and the flexibility of those structures Dr. Richardson may recommend different interventions. There are many conservative and non-operative care options to help a patient’s symptoms and these are typically used in the beginning. Surgery is only recommended after failure of these measures.
What are the Causes and Risk Factors for Flatfoot?
A flatfoot is a common condition that may be hereditary and can run in families. A non-painful flatfoot is often referred to as “pes planus”. In children a painful flatfoot may be caused by a rare condition called tarsal coalition can lead to a painful flatfoot in younger children. In this condition, two or more bones of the foot join abnormally causing stiff and painful flat feet. Sometimes there are bones in the feet that do not ossify or fuse along the arch as children get older and this can lead pain in this area, too. With adults the development of a painful flatfoot is often associated with weakness of the tendons that support the arch of the foot over time, arthritis that leads to joint degeneration of the arch, and sometimes trauma or injury.
What are the Symptoms of Flatfoot?
Children and adults with flatfoot deformity may have one or more of the following signs and symptoms:
- Inside arch of the foot is flattened
- Heel bone may be turned outward
- Inner aspect of the foot may appear bowed out
- Inability to do a single limb heel rise or walk on your toes using the affected foot
- Pain in the inside part of the ankle, causing difficulty with walking/running
- Tired, achy feet with prolonged standing or walking
- Discomfort while wearing shoes
How is Flatfoot Diagnosed?
Dr. Richardson will perform a physical examination of your foot and observe you both in standing and sitting positions. If an arch forms when you stand on your toes and the heel rolls inward, the flatfoot is typically considered flexible. X-rays are typically ordered to assess the severity of the deformity. Other higher-level imaging such as computed tomography (CT) scan or a magnetic resonance imaging (MRI) are used on an as needed basis.
What are the Treatment Options for Flatfoot?
If you do not exhibit any symptoms, Dr. Richardson may continue to monitor your condition to assess for any changes. If, however, you have symptoms related to your flatfoot, Dr. Richardson may suggest some of the following non-surgical treatments:
- Activity modification: Avoid participating in strenuous activities that cause pain such as higher impact exercise that may involve running, long hikes/walks, or sports.
- Orthotic devices: Your surgeon may advise the use of custom-made orthotic devices that are worn inside the shoes to support the arch of the foot. When pain is really severe a controlled ankle motion (CAM) boot may be recommended.
- Physical therapy: Guided stretching and strengthening exercises of the foot and ankle can provide pain relief and help resolve the problem
- Medications: Pain-relieving medications such as over the counter NSAIDs can help reduce pain and inflammation.
- Shoe modification: Wearing a well-fitting, supportive shoe with a stiff rocker-bottom sole can help relieve aching pain caused by flatfoot.
Surgery is not often needed to treat a flatfoot; however, if conservative treatment options fail to relieve your surgery may be necessary to resolve the problem. Depending on your condition, various procedures may be performed including osteotomies, tendon transfers, tendon lengthening, joint fusion, and use of various orthopaedic implants to improve obtain and maintain the corrected alignment.
If you would like to have additional information on the treatment of flatfoot, please contact Damien Richardson MD, MPH, serving the communities of Phoenix, Scottsdale, AZ.
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