  FLATFOOT IN CHILDREN AND ADULTS
Most children have flexible flatfeet, where an arch is visible
when the child is sitting, but not when the child is standing. As one gets older, the tendons that attach to the bones of the foot grow stronger and tighten, forming the arch. In many instances, the arch can "fall," creating a flatfoot. This may be due to ligamentous laxity, injury, or familial predisposition. Flatfoot in children may cause pain in the arch, tripping, and lack of desire to participate in sports and activities. Custom molded orthotics to alleviate these symptoms with great predictability and will provide a quick return to function.
There are situations where the flatfoot may become rigid over time, such as in tarsal coalition. This is a process whereby the ligaments or bones of the hindfoot become locked causing progressive stiffness. It is important to differentiate a rigid from flexible flatfoot.
If a flexible flatfoot continues into adulthood, it can contribute to lower back, knee or hip pain. The most severe complications of flatfoot in adults is weakness or tear of the posterior tibial tendon, which is commonly referred to as Posterior Tibial Tendon Dysfunction (PTTD). This may lead to chronic arch and ankle pain as well as arthritis. Systemic arthritic conditions, such as rheumatoid arthritis, may also be a primary cause of PTTD, or exacerbate the condition. Common symptoms associated with progressive flatfoot are: pain in the arch with prolonged standing, difficulty standing on one’s toes, swelling along the inner side of the arch, pain in one’s feet that reduces their ability to participate in activities of daily living, or arthritis conditions.
Treatment options for painful flatfoot may include: custom-molded foot orthotics, ankle-foot orthotics (AFOs) for more rigid bracing, anti-inflammatory medication and physical therapy.
In cases where pain and function are not improved, surgery may be needed to correct the problem. Surgical procedures can help reduce pain and improve bone alignment. The different types of surgery your physician may discuss with you may include: fusing one or more of the bones in the foot together, cutting and reshaping a bone to correct alignment, removing a bone or bone spur, cleaning the sheath covering a tendon, or using a piece of one tendon to lengthen or replace another damages tendon. treatment methods.
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• Flatfoot
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