Adult Acquire Flat Foot Deformity

Many adults have a normal flatfoot which they may have had throughout their lives. It is not painful and has never caused any limitations or disability and as such requires no treatment, being a variant of the normal anatomy of the foot.

If, however, tendon damage, foot fractures, neurological disorders, arthritis or other conditions affect the foot later in life, the arch can “fall,” creating a flatfoot and pain in the foot and ankle. If the condition progresses, problems may be had with walking, climbing stairs and wearing shoes.

What Are the Conditions of Adult Flat Foot?

Evaluation for a flatfoot should be considered if the following conditions exist:

  • the feet tire easily or become painful with prolonged standing
  • it becomes difficult to move the heel or midfoot or to stand on the toes
  • the foot aches, particularly in the heel or arch area, with swelling along the inner side
  • pain in the feet reduces the sufferer’s ability to participate in sports
  • a diagnosis of rheumatoid arthritis, as approximately half of all people with rheumatoid arthritis will develop a progressive flatfoot deformity

What Are the Reasons Flat Foot Develops in Adulthood?

A thorough examination is needed to identify why the flatfoot developed. For example, the inability to rise up on one’s toes while standing on the affected foot may indicate damage to the posterior tibial tendon (PTT). This is the tendon that supports the heel and forms the arch, and a damaged PTT is the most common reason for a flatfoot that develops in adulthood. Another indicator of damage to the PTT is when “too many toes” show on the outside of the foot when viewed from the rear, which can be evidence that the shinbone (tibia) may be sliding off the anklebone (talus).

Treatment Options for Adult Flat Foot

A painless flatfoot that does not hinder a person’s ability to walk or wear shoes requires no special treatment or orthotic device. It is the cause and progression of the flatfoot that indicate the treatment options that should be considered. Conservative treatment options include shoe modifications, using orthotic devices such as arch supports and custom-made orthoses, taking non-steroidal anti-inflammatory drugs such as ibuprofen to relieve pain, using a short-leg walking cast or wearing a brace, injecting a corticosteroid into the joint to relieve pain, rest and ice, and physical therapy.

In some cases, surgery may be needed to correct the problem. Surgical procedures can help reduce pain and improve bone alignment. The type of surgery varies with the underlying cause of the disorder, foot function, and expectations. Some of the surgical procedures may involve:

  • an arthrodesis, or welding (fusing) one or more of the bones in the foot/ankle together
  • osteotomy, or cutting and reshaping a bone to correct alignment of the foot
  • excision, or removing a bone or bone spur in the foot
  • synovectomy, or cleaning the sheath covering involved tendons
  • tendon transfer, or using a piece of one tendon to lengthen or replace another that is not functioning

Adult Flat Foot Specialist in Chicagoland

Other procedures may also be occasionally necessary and are dependent upon each individual case and cause. Dr. Vora has published and lectured extensively regarding this condition and has developed new ways to treat this condition that may allow correction of the foot while maintaining the joints of the foot, avoiding fusions and preserving mobility for some patients. Dr Vora has designed orthopaedic implants to help correct foot alignment and deformity correction that are used nationally and internationally for the treatment of this condition.

For more information on these injuries and their treatments please see: