Flatfoot deformity is a common problem associated with the lower extremity. It refers to a progressive and sometimes painful collapsing of the foot arch. There are different types of flatfoot deformities such as congenital bone and joint malformations, acquired deformities secondary to faulty biomechanics, traumatic injury, and a weakened muscle imbalance due to diseases. There is a genetic predisposition to the deformity but improper shoe gear and high impact activities over a period of time can be contributing factors.
As the deformity progresses, patients will get increased cramping and fatigue in the legs and feet, they will develop an antalgic gait, difficulty with shoe gear, unwillingness to participate in strenuous activities secondary to the pain. It can become a frustrating deformity because as the structural bone changes occur, the body tries to adapt or compensate as a result, and other joints and muscles become affected. This can result in leg, knee, hip and back pain.
The flatfoot deformity can manifest itself at an early age. Parents will notice an unusual gait pattern and a flattening of the arch. These changes are usually asymptomatic. But if the biomechanical forces that create a flatfoot deformity are not neutralized, there is a chance that the deformity will become symptomatic as the child reaches skeletal maturity. If the symptomatic flatfoot is not treated, it can lead to the formation of bunions, hammertoes, heel pain (plantar fasciitis) and chronic tendonitis of the foot.
Patients exhibiting the above mentioned symptoms, need to have the lower extremity examined by a podiatrist to determine if the symptoms are coming from the feet. The examining foot specialist will perform a gait analysis and a lower extremity joint range of motion and muscle testing as well as x-ray evaluation of the bone structures to determine if a flatfoot deformity is playing a role in the clinical presentation.
Symptomatic flat feet are treated initially with custom molded orthotics by providing structural support which neutralizes the biomechanical forces involved in flatfoot development. Treatment options include modification of activities which aggravate the symptoms, modification of shoe gear, and physical therapy to alleviate the symptoms.
When conservative options fail to reduce the flatfoot pain, surgical intervention is recommended. Depending on the severity of the flatfoot, various soft tissue (muscle, ligament) and bone procedures are used to realign the foot and ankle in order to give the patient a more functional and stable foot structure to ambulate on.
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