The normal shape of the foot has a space (arch) on the inside aspect of the foot, this is referred to as the medial arch. The depth of this arch varies from person to person as well as your age with young children often having flat feet with the development of their arch as they reach around 9 or 10 years old. It is also common for the older age groups to slowly develop flat feet with loss of the depth of the medial arch.
What are the symptoms?
Flat feet are present for some people throughout their life and can cause little or no symptoms. However if there is a difference between the arches in both feet or the shape of your foot has changed over a short period of time then this may be an indication that you need to seek a specialist opinion.
Possible causes for a progressive loss of your medial arch include arthritis of the hindfoot (heel bones) or a problem with the tendon that helps support the arch (tibialis posterior tendon). With increasing age this tendon can become inflamed and weakened and slowly looses its ability to hold the arch of the foot thus causing a flat foot. When this occurs you may experience discomfort around the inner aspect of the ankle when walking or undertaking activity sometimes associated with swelling in this area.
In childhood flat feet are most commonly caused by an abnormal fusing of the small bones in the foot that results in the foot being stiffer and less flexible.
How is it diagnosed?
It is important to take a detailed history with a subsequent examination, as there are a number of causes for flat feet. Investigations include an x-rays to define the overall shape of the foot and extent of any arthritis with the foot and ankle. On occasions additional information may be needed with more specific scans such as CT, MRI or ultrasound.
How is it treated?
Non-operative treatment – can be successful if the foot remains flexible allowing correction of the arch with simple insoles or custom made orthotic foot supports. For a number of patients this helps with the symptoms sufficiently to allow restoration of normal activities.
Operative treatment – if after trialing insoles or orthotics and the symptoms persist or if the initial symptoms are significant enough then surgery may be considered. Your surgeon will discuss all the options for surgery that included fusing (stiffening) some joints and attempting to recreate the arch of the foot. On occasions if the tendon holding the arch (tibialis posterior) is damaged then treatment or surgery may be necessary which can include transferring a tendon from nearer by to reinforce the damaged or weakened tendon.
Important: this information given above is only a guideline as is not complete. For more information or to book an appointment please contact us.