Flatfeet

Flatfeet Evaluation and Treatment in Frisco, Texas

Flatfeet—also called pes planus or fallen arches—occur when part or all of the arches lower toward the ground while standing. Flatfeet are common and do not always cause problems. Treatment is generally considered when the condition causes pain, fatigue, weakness, difficulty with activity, or progressive changes in foot shape.

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

Flexible and Rigid Flatfeet

With flexible flatfeet, the arches are visible when the person is sitting or the feet are not bearing weight, but they lower when standing. Flexible flatfeet may be painless or may cause fatigue and discomfort during prolonged activity.

With rigid flatfeet, the arches remain lowered whether the person is sitting or standing. Rigid flatfeet may be associated with arthritis, abnormal connections between bones, previous trauma, or another structural condition.

Adults may also develop progressive collapsing foot deformity, previously known as adult-acquired flatfeet 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 Flatfeet

Flatfeet may cause:

• Pain or fatigue in the arches

• 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 feet or ankles are rolling inward

• Difficulty fitting shoes or orthotics

• Weakness when standing on one foot or rising onto the toes

• Progressive changes in foot shape

Newly developing or worsening flatfeet in an adult should be evaluated because they may indicate injury or degeneration of the posterior tibial tendon or supporting ligaments.

Comprehensive Flatfeet Evaluation

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

• Examining the feet while sitting and standing

• Observing walking mechanics and alignment

• Assessing whether the arches are 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 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 a more detailed evaluation of the bones or joints is needed.

Flatfeet Treatment Options

Not everyone with flatfeet 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 causes of flatfeet

• 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 a more supportive orthotic device

• Temporary immobilization for painful tendon inflammation

• Nonsteroidal anti-inflammatory medications (NSAIDs), when medically appropriate

Choosing Supportive Shoes

The right shoes can improve comfort and help orthotics 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 shoes are not necessarily the most rigid shoes available. Recommendations should be based on the type of flatfeet, 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 a longer-term insert or orthotic is selected.

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

Over-the-Counter Inserts

Properly selected over-the-counter inserts may provide adequate support for mild symptoms or flexible flatfeet. 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 generic inserts, custom orthotics are prescribed according to the patient’s foot structure, pressure patterns, symptoms, and treatment goals.

Custom orthotics may be recommended to:

• Support the arches

• 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 new arches or reverse every structural deformity. Their purpose is to support the feet, improve function, and reduce stress on painful areas.

Physical Therapy for Flatfeet

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

Calf and Achilles tightness can increase stress on flatfeet, 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 flatfeet are flexible or rigid, the condition of the tendons and ligaments, the presence of arthritis, and the severity of the deformity.

Flatfeet 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 Flatfeet 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

• Rigid or painful flatfeet

• Uneven shoe wear or progressive changes in alignment

• Difficulty walking, exercising, or participating in sports

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