Flat feet, also known as fallen arches, is a condition where the arches of your feet are either lower than normal or absent altogether. While flat feet are common and often harmless, for some individuals, the condition can lead to pain, discomfort, and issues with mobility. In some cases, flat feet may require surgical intervention to alleviate symptoms and prevent further complications. But how do you know when surgery is necessary? In this article, we’ll explore the signs and symptoms of flat feet, when to seek treatment, and whether surgery might be right for you.

What Are Flat Feet?

Flat feet occur when the arches of the feet don’t develop properly during childhood or collapse over time due to injury, wear and tear, or underlying health conditions. In individuals with normal arches, the arch of the foot acts as a natural shock absorber, helping to distribute weight and provide balance. With flat feet, the lack of an arch can place extra strain on the feet, ankles, knees, hips, and lower back.

Types of Flat Feet

• Flexible Flat Feet: This is the most common type, where the arch appears when the person is sitting or lifting their foot but flattens when standing or walking.
• Rigid Flat Feet: In this type, the arch is absent even when the foot is lifted off the ground. Rigid flat feet often lead to more severe symptoms and discomfort.
• Adult-Acquired Flatfoot: This condition develops later in life, usually due to the degeneration or injury of the posterior tibial tendon, which supports the arch.

Common Symptoms of Flat Feet

Not all individuals with flat feet experience symptoms, but when they do, the following are some of the most common:

• Foot pain: Especially in the arch or heel.
• Swelling: Around the inside of the ankle.
• Pain in the ankles, knees, hips, or lower back: As the misalignment caused by flat feet can affect the entire kinetic chain.
• Difficulty standing on tiptoes: This is often a sign that the tendons supporting the arch are weak or damaged.
• Foot fatigue: Tiredness in the feet, especially after long periods of standing or walking.
• Shoes wearing out unevenly: This can indicate improper weight distribution due to flat feet.

When Should You Seek Medical Attention for Flat Feet?

While flat feet are not always a cause for concern, there are certain situations where it’s important to seek medical attention:

1. Persistent Pain or Discomfort

If you experience chronic pain in your feet, ankles, or legs, especially when standing or walking, it could be a sign that flat feet are causing problems. Persistent discomfort may indicate that the structures supporting your foot, such as tendons and ligaments, are under strain.

2. Difficulty Walking or Performing Daily Activities

If flat feet make it difficult for you to carry out daily activities like walking, standing, or exercising, it’s time to see a doctor. This is especially true if you find yourself avoiding physical activities because of foot pain or discomfort.

3. Swelling or Changes in Foot Shape

If you notice swelling around your ankles, or if your feet appear to be changing shape, it could be a sign that the condition is worsening. A collapsing arch can lead to increased strain on the foot and ankle, causing further complications.

4. Pain in Other Parts of the Body

Flat feet don’t just affect the feet—they can also contribute to pain in the ankles, knees, hips, or lower back. If you experience joint pain that you can’t attribute to an obvious injury, flat feet could be the underlying cause. Misalignment in the feet often leads to improper gait and posture, which can stress other parts of the body.

5. Lack of Improvement with Conservative Treatments

If you've tried conservative treatments such as custom orthotics, physical therapy, or anti-inflammatory medications, and you’re still experiencing symptoms, surgery might be the next step. While non-surgical treatments can be effective for many individuals, they don’t always provide relief, especially in more severe cases.

Non-Surgical Treatment Options for Flat Feet

Before considering surgery, most doctors recommend trying non-surgical treatments. These can often help manage symptoms and improve foot function:

• Custom Orthotics: Specially made shoe inserts can provide support and help realign the foot, reducing pain and discomfort.
• Physical Therapy: Strengthening exercises, particularly for the muscles and tendons supporting the arch, can help alleviate symptoms.
• Supportive Footwear: Wearing shoes with good arch support and cushioning can relieve pressure on the feet.
• Anti-Inflammatory Medications: Over-the-counter medications such as ibuprofen can help reduce pain and inflammation.
• Weight Management: For individuals who are overweight, losing weight can reduce the strain on the feet and alleviate symptoms.

When Is Foot Surgery for Flat Feet Necessary?

Surgery is usually only recommended for flat feet in cases where non-surgical treatments have failed to provide relief, or when the condition has led to severe symptoms or deformities. Here are some situations where surgery might be the best option:

1. Severe Pain and Deformity

When flat feet cause severe pain or lead to deformities like bunions or hammertoes, surgery may be necessary to correct the problem and restore function. In cases of adult-acquired flatfoot, the collapse of the arch can also cause the foot to roll inward (overpronation), leading to significant pain and difficulty walking.

2. Torn or Damaged Tendons

In some cases, the tendons that support the arch, such as the posterior tibial tendon, can become torn or damaged due to flat feet. If this happens, surgery may be required to repair or replace the damaged tendon to restore the foot's structural integrity.

3. Progressive Condition

Flat feet can worsen over time, particularly in cases of adult-acquired flatfoot. If your condition is progressively getting worse, and conservative treatments no longer provide relief, surgery may be necessary to prevent further deterioration.

Types of Flat Foot Surgery

There are several surgical procedures available for treating flat feet, depending on the severity of the condition and the patient’s individual needs. Some of the most common procedures include:

1. Tendon Transfer Surgery

In cases where the posterior tibial tendon is damaged, tendon transfer surgery can be performed. This involves transferring a healthy tendon from another part of the foot to take over the function of the damaged tendon.

2. Osteotomy

An osteotomy is a surgical procedure in which the bones in the foot are cut and realigned to restore the arch. This is often done in combination with other procedures like tendon repair or lengthening.

3. Arthrodesis (Joint Fusion)

In severe cases of flatfoot, particularly when arthritis is present, joint fusion may be necessary. This involves fusing one or more of the foot's joints to improve stability and reduce pain.

4. Lateral Column Lengthening

This procedure involves lengthening one of the bones in the foot (the calcaneus) to help restore the arch and correct overpronation.

Recovery and Rehabilitation After Surgery

Recovery from flatfoot surgery can take several months, depending on the type of procedure performed. Patients typically need to wear a cast or boot for 6-8 weeks and may require physical therapy to regain strength and mobility. While surgery can be highly effective in alleviating symptoms, it’s important to follow your surgeon’s recovery plan closely to ensure the best possible outcome.

Schedule Your Consultation Today for Pain Relief

Flat feet are a common condition, but they can lead to serious discomfort and complications if left untreated. If you’re experiencing persistent pain, difficulty walking, or worsening symptoms despite conservative treatments, it may be time to consider foot surgery.

At Prisk Orthopaedics and Wellness, we specialize in diagnosing and treating foot conditions, including flat feet. Contact us today to schedule a consultation and take the first step toward relieving your symptoms and restoring your mobility.