Flat Feet

Flatfeet is a common condition, also known as flatfoot, in which the arches on the inside of the feet flatten when pressure is put on them. When people with flatfeet stand up, the feet point outward, and the entire soles of the feet fall and touch the floor.

Flat Feet

Low Arch Feet

Pes plans is the scientific term that describes the low arch or "flat" feet. As podiatric physicians, we are very interested not only in structure but also in function of the feet. While very few people have 20-20 vision, it is also true that very few people have perfect arch structure. High and low arch feet are just the two ends of the spectrum of foot structure. The more deviation from what is considered perfect, the worse the function becomes.

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We describe deviation from "the ideal" as imbalance in structure. It is the imbalance in structure that leads to abnormal function. Abnormal function causes pain and/or deformity. Deformity can manifest itself in a variety of foot problems such as bunions or hammerttoes. Likewise, pain can manifest itself in a variety of ways such as heel pain ( plantar fasciitisor or help spur), corns or calluses, metatarsalgia or pain in the ball of the foot (neuromas, stress fractures, or tendonitis), even in pediatric cases. Invariably, we can treat most foot imbalance or biomechanical insufficiencies with orthotic therapy.

As a general rule, Flat Feet procedures are performed on an out-patient basis in an Alberta Health Services (AHS) approved Surgical Center or in a Hospital. Surgical procedural costs are covered by AHS or the patient may opt for private surgery to avoid a waiting time. A visit to Feldman & Leavitt Foot And Ankle Specialists will CLEARLY define all available patient options.

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Frequently Asked Questions

What exactly is Flatfeet?

It is characterized by a progressive flattening of the arch of the foot/feet. The posterior tibial tendon (a tendon in your lower leg) wears down, causing flattening. Other names for it include posterior tibial tendon dysfunction, posterior tibial tendon insufficiency, and dorsolateral peritalar subluxation. This condition can progress from early stages of pain and swelling along the posterior tibial tendon to full arch collapse and arthritis throughout the hindfoot and ankle.

What are the typical symptoms of Flatfeet?

Deformity of the foot and ankle may occur as the tendon fails over time. The following are examples of deformities:
flattening of the arch over time shifting the heel outward so that it is no longer aligned underneath the rest of the leg
Forefoot rotational deformity the heel cord is being tightened the emergence of arthritis ankle joint abnormality
Pain may shift from the inside to the outside of the ankle at various stages of this disorder as the heel shifts outward and structures on the outside of the ankle become pinched.

What are some of the most common causes of Flatfeet?

The most common cause of Flatfeet is posterior tibial tendon dysfunction. Often, there is no single event or injury that triggers the problem. The tendon is more commonly injured as a result of "wear and tear" over time. Patients who are born with a flat foot/feet or who develop the condition for other reasons are more likely to have posterior tibial tendon dysfunction. A relatively flat arch puts more strain on the posterior tibial tendon as well as the ligaments on the inside of the foot and ankle. As a result, the disorder worsens. Weight also contributes to the progression of this disorder. Significant weight loss may result in some improvement of symptoms in overweight patients.

Do I need to take any medications to treat flatfeet?

Treatment depends very much upon a patient's symptoms, goals, severity of deformity, and the presence of arthritis. Some patients get better without surgery. Rest and immobilization, orthotics, braces, and physical therapy all may be appropriate.

In the early stages of disease, immobilization with a boot for a period of time can relieve stress on the tendon and reduce inflammation and pain. After these symptoms have subsided, patients may begin using an arch support or orthotic that supports the inside of the hindfoot. A larger ankle brace may be required for patients with a more severe deformity. Non-surgical treatments for advanced flatfeet may slow the disorder's progression and alleviate symptoms, but they will not correct the deformity.
If surgery is required, a variety of procedures may be considered. The specifics of the planned surgery are determined by the stage of the disorder and the specific goals of the patient.
Ligament and muscle lengthening, removal of inflamed tendon lining, tendon transfers, cutting and realigning bones, implant placement to realign the foot, and joint fusions are all possible procedures. Early stage disease can usually be treated with tendon and ligament procedures, as well as osteotomies (bone cutting/shortening) to realign the foot.

Joint fusion procedures are typically used to treat advanced disease with either a rigidly fixed deformity or arthritis. Fusions involve the removal of the joint that connects two bones, causing them to fuse together. These procedures provide powerful correction of deformities, resulting in increased stability and pain relief; however, they also result in a stiffer foot and loss of motion.

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For more information on Flat Feet, book a surgical consultation with one of our board certified podiatric surgeons

For more information on Flat Feet, book a surgical consultation with one of our board certified podiatric surgeons

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