Flat feet are a common condition. In infants and toddlers, the longitudinal arch is not developed and flat feet are normal at certain times but may require treatment. Most feet are flexible and an arch appears when the person stands on his or her toes. The arch develops in childhood, and by adulthood most people have developed normal arches. It is important to get your child into a good Pediatric orthotic as soon as possible in order to avoid problems in the future especially if there is a family history of flat feet. In a small percentage of kids even as young as 6 years old a simple out patient procedure where a small stent is used to hold the foot or Talus bone in the correct psoition and correct the flat foot.
Most flat feet usually do not cause pain or other problems but about 15% can and will cause problems. Flat feet may be associated with hyper-pronation, a leaning inward of the ankle bones toward the center line. Shoes of children who pronate, when placed side by side, will lean toward each other (after they have been worn long enough for the foot position to remodel their shape).
Foot pain, ankle pain or lower leg pain and back pain, especially in children, may be a result of flat feet and should be evaluated.
Painful progressive flatfoot, otherwise known as Tibialis Posterior Tendonitis, is caused by inflammation of the tendon of the tibialis posterior. The tendon then becomes inflamed, stretched or suffers a partial or total tear. If left untreated, this condition may lead to severe disability and chronic pain. Some people are predisposed to this condition if they have flat feet or an abnormal attachment of the tendon to the bones in the midfoot.
Nonsteroidal anti-inflammatory medications, ice, physical therapy, supportive taping and bracing, or orthotic devices are the common ways of treating painful progressive flatfoot. Depending on how flat the foot is and whether or not conservative treatment is working surgery may be needed. This can be as simple as an outpatient procedure taking 30 minutes or very complex reconstruction. A full evaluation is needed including weight bearing x-rays to determine the appropriate procedure. The new Hyprocure Implant is a great new option for patients. See www.hyprocure.com
