Flat foot is a very common condition that is often non-pain causing and does not cause any limitations or disability. In certain instances, where a foot or ankle issue occurs, the arch of a “healthy” foot can fall, causing a flatfoot. This type of flatfoot can come with severe pain in the foot and ankle, as well as difficulty walking, climbing stairs, and wearing shoes. Flat foot can occur in both adults and adolescents, but is more severe when affecting adults.
One of the main tendons in the foot is the posterior tibial tendon. This tendon begins in the calf and stretches down to the middle of the foot. It’s vital for providing support when stepping and pushing off of the toes. If this tendon becomes damaged, it can lead to gradual lose of the inner arch. Most treatments for this condition are non-surgical, but if conditions worsen, surgical options ranging from tenosynovectomy, osteotomy, and tendon transfer may be utilizes to repair the damaged tendon.
The spring ligament is a band of tissue that supports the bones of the midfoot. Dr. Vora and the IBJI team have developed a corrective method for spring ligament injury that provides additional correction for those suffering from flatfoot pain. The result of this additional correction can lead to quicker recovery time and less surgeries required to correct foot positioning.
Children are born with flexible flat foot, a condition that most will eventually outgrow without any lasting issues. We see many parents who worried about their child’s flat foot, but we reassure them that, as the child continues to walk, their foot will strengthen and the arch will continue to take shape. Treatments for childhood flexible flat foot range from stretching and physical therapy, to orthotic inserts, and in rare cases, surgical treatment to relieve pain.
Tarsal coalition is a condition of the hind foot, where the tarsal bones will fail completely separate as the body grows. Many patients have this condition but experience no pain. In instances where separation is not present, an immobilization treatment is utilized to allow the two edges of the bone to stabilize. If arthritis is present at the hind foot, a fusion of the joints may also be necessary to correct the tarsal coalition and its related pain.
One of the most important bones in the foot, the navicular, is the anchor point for the posterior tibial tendon. This tendon is vital to balance within the foot. Adolescent patients experiencing an accessory navicular have an extra bone or piece of cartilage in the navicular’s area that may lead to rubbing and pain. Immobilization is often the best course of treatment for this condition, but in some cases, a surgical removal of the accessory navicular bone, paired with a reattachment of the posterior tibial tendon, may be required.
If you think you or your child may be suffering from flat foot or any other foot related injury, be sure to schedule an appointment with Dr. Anand Vora today. As one of Illinois’ leading orthopaedic foot and ankle specialists, he would be happy to assess your pain and come up with the best treatment option for your individual body.
For more information on these injuries and their treatments please see:
Why do we get flat feet? What are our options?
As explained by Dr. Anand Vora.
As far as flat feet go, there are really two different main branching points – what flat feet are and how they occur. So the first is a congenital variant, and that means that we were born with flat feet and we inherited that from our family or from our parents. There’s a congenital predisposition in certain people to have a flat foot. In those particular patients, almost always, the pain will be negligible or manageable with conservative treatment such as bracing and orthotics. We really try to be very conservative on these patients because it’s just simply a spectrum of normal.
How do you treat flat feet developed later in life?
The second subgroup of patients (the majority of patients that we treat more aggressively for flat foot problems) are those that develop flat feet later in life. The reason this occurs in particular patients is due to a tendon on the inside of the ankle called the posterior tibial tendon, and it’s a tendon that serves like a pulley on the inside part of the ankle that runs into the foot. When that pulley becomes damaged for any type of reason, it can no longer do its job to maintain the arch of the foot. One of the ligaments, called the spring ligament, also oftentimes compromises and becomes lax and loose and redundant, and over time the foot starts to collapse and the arch collapses. In these particular patients, pain is much more of a significant issue. Usually, one foot will become flatter than the other, so we refer to that as an asymmetric flat foot, contrasting that one foot is different. In these patients, the treatment options become much more complex. They involve orthotics or bracing whenever possible, but oftentimes surgery is needed to reconstruct the arch of the foot by doing surgical cuts to the bone and repairing the tendons, or doing tendon transfers to repair the damaged tissue that led to the original problem.