Flatfoot

Flatfoot Evaluation and Treatment in Frisco, Texas

Flatfoot—also called flat feet, pes planus, or fallen arches—describes a foot in which part or all of the arch lowers toward the ground when standing. Flat feet are common and do not always cause a problem. Treatment is generally considered when the condition produces pain, fatigue, weakness, difficulty with activity, or progressive changes in the shape of the foot.

Flatfoot can affect children and adults. Some people have flexible flat feet from an early age, while others develop a progressively collapsing arch later in life because of tendon or ligament problems, arthritis, injury, or other factors.

Flexible and Rigid Flatfoot

A flexible flatfoot has an arch when the person is sitting or when the foot is not bearing weight, but the arch lowers when standing. Flexible flat feet may be painless or may cause fatigue and discomfort during prolonged activity.

A rigid flatfoot remains flat whether the person is sitting or standing. This may be associated with arthritis, an abnormal connection between bones, previous trauma, or another structural condition.

Adults may also develop progressive collapsing foot deformity, previously known as adult-acquired flatfoot or posterior tibial tendon dysfunction. This condition can begin with pain and swelling along the inside of the ankle and gradually lead to arch collapse, outward rotation of the foot, weakness, and difficulty standing on the toes.

Symptoms Associated With Flat Feet

Flat feet may cause:

• Pain or fatigue in the arch
• Pain or swelling along the inside of the ankle
• Heel, ankle, knee, hip, or lower-leg discomfort
• Tired or aching feet after standing or walking
• Difficulty walking, running, or participating in sports
• Uneven shoe wear
• A sensation that the foot or ankle is rolling inward
• Difficulty fitting shoes or orthotics
• Weakness when standing on one foot or rising onto the toes
• Progressive changes in foot shape

A newly developing or worsening flatfoot in an adult should be evaluated because it may indicate injury or degeneration of the posterior tibial tendon or supporting ligaments.

Comprehensive Flatfoot Evaluation

At Modern Podiatry, Dr. Woojung Lee performs a thorough examination to determine the type, severity, and possible cause of the flatfoot. The evaluation may include:

• Examining the feet while sitting and standing
• Observing walking mechanics and alignment
• Assessing whether the arch is flexible or rigid
• Evaluating joint motion and ankle flexibility
• Testing muscle and tendon strength
• Checking for tenderness, swelling, arthritis, or instability
• Examining shoe-wear patterns
• Comparing the alignment of both feet and ankles

Weight-bearing X-rays may be obtained in the office. Images taken while standing can show how the bones and joints align under normal body weight and can help identify arthritis, deformity, or other structural problems.

Advanced imaging may be ordered when clinically necessary. Ultrasound or MRI can provide additional information about tendons, ligaments, and other soft tissues. CT imaging may be considered when more detailed evaluation of the bones or joints is needed.

Flatfoot Treatment Options

Not every flatfoot requires treatment. When symptoms are present, Dr. Lee develops an individualized plan based on the patient’s age, foot structure, flexibility, symptoms, activities, footwear, and imaging findings.

Nonsurgical treatment may include:

• Education about the type and cause of the flatfoot
• Activity modification
• Taping or strapping for temporary support
• Supportive shoe recommendations
• Over-the-counter arch supports
• 3D-scanned custom orthotics
• Stretching and strengthening exercises
• Physical therapy
• An ankle brace or more supportive orthotic device
• Temporary immobilization for painful tendon inflammation
• Nonsteroidal anti-inflammatory medications (NSAIDs), when medically appropriate

Choosing Supportive Shoes

The right shoe can improve comfort and help an orthotic function correctly. Dr. Lee may recommend footwear with:

• A firm heel counter
• A stable sole that does not twist excessively
• Appropriate arch and midfoot support
• Adequate width and depth
• A removable liner to accommodate an insert
• Proper sizing for the patient’s foot shape and activity

The most supportive shoe is not necessarily the most rigid shoe available. Recommendations should be based on the type of flatfoot, symptoms, activity, and intended use.

Taping and Temporary Support

Taping or strapping may provide temporary arch support and reduce strain on painful tissues. It can also help demonstrate whether increased support improves a patient’s symptoms before selecting a longer-term insert or orthotic.

Taping is not generally intended as a permanent correction. Skin sensitivity, circulation, activity level, and proper application should be considered.

Over-the-Counter Inserts

A properly selected over-the-counter insert may provide adequate support for mild symptoms or flexible flat feet. Dr. Lee can help patients understand which features to look for and whether an available insert is appropriate for their foot type and shoes.

An insert that is too soft, too rigid, or poorly fitted may fail to provide useful support and can sometimes cause discomfort in another part of the foot.

3D-Scanned Custom Orthotics

Modern Podiatry offers custom orthotics designed from a 3D scan of the feet. Unlike a generic insert, a custom orthotic is prescribed according to the patient’s foot structure, pressure patterns, symptoms, and treatment goals.

Custom orthotics may be recommended to:

• Support the arch
• Improve pressure distribution
• Reduce excessive motion
• Support a painful posterior tibial tendon
• Improve comfort during standing or walking
• Accommodate differences in foot structure
• Work with specific occupational or athletic footwear

Orthotics do not permanently create a new arch or reverse every structural deformity. Their purpose is to support the foot, improve function, and reduce stress on painful areas.

Physical Therapy for Flatfoot

Physical therapy may help improve strength, flexibility, balance, and walking mechanics. A program may include exercises targeting the posterior tibial tendon, calf muscles, intrinsic foot muscles, and other structures that support the arch.

Calf and Achilles tightness can increase stress on a flatfoot, so stretching may also be included. Exercises should be selected according to the diagnosis and performed correctly to avoid aggravating a painful tendon or joint.

When Is Surgery Considered?

Surgery may be considered when significant pain, progressive deformity, or functional limitations continue despite appropriate nonsurgical treatment. The procedure depends on whether the flatfoot is flexible or rigid, the condition of the tendons and ligaments, the presence of arthritis, and the severity of the deformity.

Flatfoot reconstruction may require more than one procedure to address the different components of the deformity. Dr. Lee will explain the expected benefits, limitations, risks, alternatives, and recovery before recommending surgery.

When Should Flat Feet Be Evaluated?

Schedule an evaluation if you experience:

• New or worsening arch collapse
• Pain or swelling along the inside of the ankle
• Difficulty standing on your toes
• Persistent foot fatigue or arch pain
• Recurrent ankle problems
• A rigid or painful flatfoot
• Uneven shoe wear or progressive changes in alignment
• Difficulty walking, exercising, or participating in sports

Modern Podiatry provides comprehensive flatfoot evaluation, on-site X-rays, footwear education, over-the-counter and 3D-scanned custom orthotics, and individualized treatment in Frisco, Texas.