Links in this section:
» Foot & Ankle Surgery
» Arthroscopic Surgery
   of the Foot & Ankle
» See Surgical Video
   of Platelet Gel Application

Low Arches, Flat Feet Pain & Treatment

Arch Pain

Low-arched or flat feet are very common. It has been estimated that 70% of the general population has a tendency towards excessive inrolling problems of the foot. Some of the more common causes of flat feet are heredity, muscle imbalance, and faulty foot structure. Low-arched feet, unlike high-arched feet, are usually flexible and absorb shock well. They are often associated with foot deformities such as bunions, hammertoes, callouses, heel spurs, tendon injuries, and leg and back pain. Conservative care using shoe modifications, padding, arch supports, and physical therapy is sometimes effective.

Types of Flat Feet

There are two basic types of flat feet: rigid and non-rigid. The difference between the two types is determined by standing and sitting positions. While standing, see if the foot flattens or lowers in the arch area. Then, pick up the foot and see if the arch height increases. If it does it is a non-rigid type. Conversely, the rigid type arch remains the same with or without weight on it.

Rigid flat feet occur less frequently and are often associated with abnormal bridges of bone in the hind foot that prevent the joints from working properly. Without adequate movement, the muscles that move the foot and leg go into spasm and cause pain. Surgery unlocks the bones and normal motion returns. It takes six to eight weeks to recover from this surgery which helps to build a foot with an arch.

The non-rigid foot is the most commonly seen flat foot condition. Young children often go untreated and can suffer from major foot problems when they are older. Conservative care such as arch cookies, special shoes, orthotics, and exercises are used to support and strengthen the muscles of the leg and foot. If these are unsuccessful, surgery can help. We must remember that young children usually do not complain of painful flat feet. They do, however, demonstrate that they do not like to wear shoes, tend to run their heels over, and generally are clumsy. Some complain of night cramps. Most often, there is a strong hereditary tendency in children with flat feet. Sometimes examining the child’s parents helps predict what foot conditions may appear later in life if left untreated.

An important difference in the flat foot of a child verses that of an adult is that much of the foot structure in a child is still cartilage and will continue to grow as they get older. Unlike the child’s foot, an adult foot has all of the bones already formed. The foot bones are usually fully grown at the age of twelve for girls and fourteen for boys. Therefore, the earlier the surgery, the better the results because of the growth that occurs after the foot has been properly positioned.

Flat Foot Treatment & Surgery

An excellent procedure to correct a flat foot is the Smith Sta-Peg operation. A small piece of angled plastic is inserted between two bones in the foot structure which prevents the arch from collapsing. Both feet can be done at the same time, walking is allowed the day after surgery, and there is no need for casts.

If the excessive flattening of the foot is reduced, the bones will develop normally. This surgery prevents problems such as bunions, calluses, and hammertoes from occurring later in life.

In older children and adults surgery also involves supporting the structures of the inside of the foot. A wedge of bone is removed from the middle of the arch area that sags and a new, normal arch is created. A common cause of flat feet in an adult is a partially or completely ruptured posterior tibial tendon. As previously described under Tendon Injuries, this often causes flattening of the arch and tilting of the heel bone. The ruptured tendon is supported with another tendon and the heel bone can be repositioned. These procedures help support the arch by restoring normal function to the torn tendon and heel.

In older children and adults, the tendon that supports the arch (posterior tibial tendon) is often partially or completely torn. This causes continued flattening of the arch and tilting of the heel bone. If conservative care is not successful, the ruptured tendon is supported with another tendon, and the heel bone can be repositioned. This procedure helps support the arch, by restoring normal function to the torn tendon and heel.

Sometimes a tight heel cord adds to the excessive pressure on the foot and causes it to flatten. Lengthening it helps relieve this pressure and restores the arch to its normal height.

A proper evaluation of the causes of a flat foot determines the best surgical course needed to correct the deformity. A bone wedge procedure or tendon lengthening in combination with other procedures extends the recovery time, but benefits the patient for a lifetime.

Conclusion on Flat Feet Pain

Unfortunately many people think little can be done to correct flat feet. This misconception is from a lack of education and understanding about this often overlooked problem. Selected surgical procedures can correct this common condition.

back to top