Ask the Experts Blog

Flat feet can cause serious pain and lead to further issues down the line if not properly treated early on. There are many factors that can lead to flat feet. The most common being genetics, trauma, an accessory bone within the tendon, and a coalition, which is an abnormal connection between two bones near the ankle which act as a tether, and the foot can subsequently become flat.

What are the symptoms?

Symptoms for flat feet typically include pain at the inside or outside of the ankle. Increased activity, prolonged standing, and walking on uneven ground can also cause a great deal of pain for a person with flat feet.

Who’s at risk?

Women are three times more likely to have flat feet than men. Although flat feet can happen at any age, it is most commonly seen in middle aged adults.

What treatment options are available?

“What we’ve also known through years of data is this is a progressive disease,” said foot and ankle specialist, James Maskill, DPM. 

“There are four stages of posterior tendon dysfunction (PTTD), also known as adult-acquired flat feet. The stage you are in is a big factor in determining the treatment you need.”

• Stage 1: During this stage, you have pain and weakness within the tendon, but you have a normal foot, and no deformity.
• Stage 2: Pain occurs along the tendon, or the outside of the foot and ankle become painful. However, your flat foot is flexible. This means you can still turn your foot from side to side. A person in stage two can usually walk on uneven ground with no issues.
• Stage 3: The in and out movement in your foot has become fixed. This means it is now arthritic. This typically happens after years of having flexible flat feet without treatment.
• Stage 4: After years of having a fixed deformity, your ankle turns and becomes flat. This causes you to almost walk on your ankle bone.

“We try to stop the disease at whatever stage the patient comes in with. The last thing I want is for someone to progress to the next stage because it becomes more difficult and the outcomes may not be as good with conservative or surgical management,” said Dr. Maskill.

Conservative treatment options include custom orthotics, bracing, medication, injections, and physical therapy. However, the most important thing you can do is stretch your Achilles tendon. The Achilles tendon is one of the strongest tendons in your body and gives your foot the ability to move up and down. Flat feet causes this tendon to become tight and stretching can help relieve some of that stress.

Here are three easy steps to stretch your Achilles tendon:

1. Put the front half of your feet on the edge of a stair or any stable raised platform.
2. Hold on to a railing or another form of support to maintain your balance.
3. Slowly lower your heels to the lowest point possible without pain and back up again.

If there is no progress with conservative treatment, patients may eventually need surgical treatment. The type of surgery needed depends again on the stage of PTTD you are in.

“I’ve seen flat feet in people from age eight to 80,” said Dr. Maskill. “If it’s painful, it’s treatable.”

For more information on flat feet, watch the video below: