Are Fallen Arches a Real Foot Problem?

Eric F. Caporusso, DPM Podiatry
Chippewa Valley Orthopedic and Sports Medicine, Eau Claire

Is fallen arches a real foot disorder, or just a catch phrase used to describe chronically sore feet? Actually, fallen arches—or flat feet, is a legitimate medical condition that affects about 25 percent of the US population. Flat feet can be present at birth, or develop over decades of walking, running and overall time spent on the feet, especially on hard surfaces in the workplace.

There are several types of flatfoot conditions that occur in adults. The most common is adult-acquired flatfoot, which is caused by overstretching a tendon that supports the arch of the foot. This leads to a partial or complete collapse of the arch and produces the flattened appearance on the bottom of the foot. Another common type is flexible flatfoot in which the foot is flat when standing and returns to a normal arch in non-weight-bearing positions.

In adults, flat feet can be very painful and limit your mobility. It’s tough to be active and maintain a healthy lifestyle if your feet hurt constantly, so it’s important to seek medical attention to identify the problem early, before it progresses to a serious, activity-limiting foot problem.

The red line represents the arch for a person with flat feet. The white line represents the location of the rebuilt arch after surgery to repair the condition.

Pain is the primary reason patients seek medical treatment for flat feet. Initial therapy may include activity modifications or limitations, stretching exercises, physical therapy, custom shoe orthotics and non-steroidal anti-inflammatory medications. If the condition worsens, pain and tenderness in the arch becomes more severe and some patients may not be able to rise up on their toes without pain or at all. Typically, there is a vicious cycle of events. As the pain worsens, there is a decrease in activity level. Decreased activity leads to weight gain, decreased fitness and overall poor health. Flat feet are considered pre-arthritic conditions. If the flatfoot is not rebalanced, osteoarthritis can occur. Arthritis in the ankle, knee, hip and back can occur because of long-standing flat feet.

If the response to initial treatment is unsatisfactory, a variety of surgical options may be considered to relieve pain and improve foot function. Procedure choices depend on several factors, including age, overall health, weight, activity level, severity and flexibility of the flat foot, and the presence of arthritis, to name a few. In flexible flat feet, often times soft tissue balancing can be performed by lengthening or tightening tendons and ligaments to rebuild the arch. In cases where the flatfoot is more severe, bones may need to be cut and shifted to help build the arch. In cases where severe arthritis has set in, the bones involved may need to be fused together to rebuild the arch. In certain cases, combinations of procedures may be required to achieve a better arch. After surgery, physical therapy is often utilized. Outcomes after surgery are typically very good, with an overall reduction in pain and improvement in activity level.

For more information or to schedule an appointment with Dr. Eric Caporusso » 715.832.1400, Chippewa Valley Orthopedics and Sports Medicine