Adult dysfunctional flatfoot is a term used to describe a low arch disorder which requires treatment due to evident pain or deformity when bearing weight. There are many “flatfooted” individuals that have developed without conditions to cause discomfort or hinder activity that do not need treatment. If you have any questions about your feet being flat, please consult a podiatrist. A juvenile or pediatric dysfunctional flatfoot can be considered a different condition due to differing causes and treatments sometimes.
Symptoms of adult dysfunctional flatfoot can be greatly varied depending on the cause. Typically there will be heel pain or arch pain. Occasionally knee, hip, or back pain will be the only complaint. Most patients know there feet are flatter than others and may see a progression over time that there foot has become flatter.
Causes of a flatfoot can generally be congenital, acquired, or components of both. Congenital deformities are due to heredity and the structure of your bones and joints when you were born. Some examples of congenital causes of flatfeet are; ligamentous laxity, calcaneal valgus, vertical talus, tarsal coalition, neuromuscular disorders, equinus, limb length discrepancy, and torsional or angulational leg deformities. Acquired deformities develop as your bones and joints develop and can be due to biomechanical deformities, systemic diseases, or trauma. The posterior tibial tendon is one of the main supporting tendons for the arch. Trauma to this tendon can result in a tendon rupture or posterior tibial tendon dysfunction (PTTD). Both will allow the collapsing of the arch due to a relaxed tendon. These are just a few examples as the causes are too numerous to mention.
Problems associated with a flatfoot are numerous. Common disorders are heel spur syndrome, plantar fasciitis, arthritis,sinus tarsi syndrome, tarsal tunnel syndrome, bunions, and hammertoes.
Prevention of these associated problems is easier than prevention of developing the flatfoot in the first place. Prevention is aimed at the biomechanics of your foot and having it function properly. If excessive pronation is the cause of foot problems, then realigning the foot to function in more of a “normal” pattern may be the best prevention. The best prevention may be to get advice from your podiatrist.
Podiatric Care is varied as it depends on age, weight, activity level, expectations, causes, and symptoms. When you go to your doctor, x-rays are usually required to evaluate the structure of your foot and determine if a bunion is truly the problem. They may advise you on different shoewear or prescribe a custom made orthotic to try and control the foot structure especially if you have excessive pronation. Your podiatric physician may also recommend a surgical procedure to actually fix the structural problem of your foot.