Adult-acquired flatfoot is a condition wherein the main tendon in your foot—known formally as the posterior tibial tendon—gets damaged and stops doing its job of holding the structure of your foot together. As a result, the arch of your foot collapses—hence the name "flatfoot."
There is usually no single sudden cause of adult-acquired flatfoot. It is more common in people whose feet tend to roll in when they walk, which places more stress on the tendons and ligaments involved in supporting the foot’s natural arch.
Symptoms of Adult-Acquired Flatfoot
Adult-acquired flatfoot tends to come on slowly, so you may not even be aware of what is happening at first. Some things you might notice include:
Pain inside your rear and mid-foot
The first sign of damage to the posterior tibial tendon is often a pain inside the foot, which occurs as the foot’s structure starts to change.
Pain in the ankles, or ankles that turn inward
Similarly, you might first notice the pain in your ankles, where the tendon starts.
Feet that touch the floor without any noticeable arch
As the tendon deteriorates further, your foot structure will change and any arch you may have had will disappear.
In advanced cases, all over foot pain can make walking difficult to impossible.
A trained podiatrist can detect those stages and diagnose where on the spectrum of adult flatfoot your feet are. That helps plan the best course of treatment for you and your feet.
Stages of Adult-Acquired Flatfoot
When we examine your feet, we will determine what stage of adult-acquired flatfoot your feet are in and then develop an individual treatment plan designed to address your pain and to get you up and moving and back to your old life as quickly and safely as possible.
At every point along the way, we want you to feel supported and as though you are in the hands of a trusted expert. Dr. Scudday has over 20 years of experience in treating problems just like yours.
Stage 1. Pain and Swelling
At Stage 1, you will start to experience tendinitis—the technical term for pain and swelling in a tendon. In this case, the pain is in the posterior tibial tendon that holds your foot together. You will have pain in your foot or ankle, but your arch will still be intact.
We will start by treating your pain with oral anti-inflammatories, steroid injections, and often a brace or cast to help immobilize the foot. For many patients, we will also prescribe custom orthotics, which are devices you wear inside your shoes that are specifically designed for your feet. Minimally invasive surgery might be recommended in certain cases.
Stage 2. Flat Feet
In Stage 2, the tendon begins to lengthen and sometimes rupture, causing your arch to collapse and all of your foot to touch the floor. If you thought the pain you experienced in Stage 1 was just going to go away eventually, by Stage 2 you might start to think something is really wrong, as you will be able to see and feel the way your feet are changing shape.
Treatment for Stage 2 begins with the same kinds of interventions as Stage 1, including treating the pain with anti-inflammatories and steroid injections, followed by braces and custom orthotics to help stabilize your feet.
If those treatments do not work, the next stage is surgery to repair the tendon and reconstruct the arch. While we know the mere mention of surgery often scares people, the surgical interventions are typically minimally invasive surgeries that will restore the arch of your foot and maintain its mobility.
Stage 3. Arthritis and Rigidity in the Foot
Most patients will notice the symptoms of adult-acquired flatfoot and seek treatment well before they reach Stage 3, where the foot becomes rigid and arthritis sets in, but even if you do not catch your symptoms until you get to this point, there are still treatments available.
Stage 4. Arthritis Moves to the Ankle
Stage 4 is much like Stage 3, except that now your ankle will begin to become arthritic as well as your foot. Again, most patients will notice a change in their foot far before the problem reaches their ankle, but even if you don’t, help is still available.
Surgeries for Flatfoot
Depending on the exact nature of your feet, you may be a good candidate for surgery that will reconstruct the arch in your foot and repair misalignment caused by the damaged tendon, leaving you free from pain and with feet that feel like new. There are three main types of surgeries we perform:
- Tendon transfers. In a tendon transfer, a tendon from elsewhere in the body is transferred to replace the damaged tendon.
- Osteotomies. In an osteotomy, the heel bone is modified and shifted to realign the foot and the tendon.
- Fusions. In a fusion, the joints are fused together to strengthen them and eliminate the source of your pain.
Tendon transfers and osteotomies are considered minimally invasive surgeries. They are typically used in Stage 1 or Stage 2. Minimally invasive surgeries are lower risk, and we have decades of experience performing them and making sure patients are comfortable and cared for throughout.
Fusions are considered open surgeries. A fusion can correct arthritis, which is why this procedure is not used until you’ve reached Stage 3 or Stage 4. However, this surgery offers a permanent solution for your flat feet. A successful surgery should let you get back to your normal life without needing to worry about the recurrence of your pain.
While any type of surgery can sound scary, rest assured that you are in good, experienced, and careful hands when you come to Dr. Bruce Scudday. He has more than two decades of experience in getting people just like you up on their feet and walking again, all the while taking time to make sure that your treatment is right for you, your life, and your goals.
Do You Need the Help of an Experienced and Caring Podiatrist? Contact Our El Paso Foot Doctor Today.
If you're experiencing any type of foot pain you should speak with an experienced podiatrist as soon as possible. Please contact us online to schedule your appointment or call one of our convenient El Paso offices directly. To reach our Sierra Tower Building podiatrist office please call 915.533.5151. You can find driving directions here. To reach our George Dieter Drive podiatry office please call 915.856.3331. Driving directions are available here.