What is Flatfoot?
Flatfoot is a foot deformity characterized by partial or total collapse (loss) of the arch on the inside of the foot. The deformity may also cause the toes and front part of the foot to point outward and the heel to tilt towards the outside. In severe cases, the ankle may even appear to turn in. Bunions and hammertoes may develop as a result from the foot instability caused by a flatfoot.
Flexible flatfoot is one of the most common types of flatfoot. When a patient with a flexible flatfoot stands, their arch is flat. However, when the patient is not standing their arch returns and appears normal. Flexible flatfoot usually affects both feet and typically begins in childhood or adolescence and continues into adulthood. This deformity is progressive and therefore can increase in severity over time. As the deformity worsens, the soft tissues (tendons and ligaments) of the arch may stretch or tear and can become inflamed.
Symptoms of flexible flatfoot
- Pain in the heel, arch, or inside of the ankle
- A visibly flattened arch when standing, but returns to normal when sitting.
- General aching or fatigue in the foot or leg
- Knee, hip, or lower back pain
Posterior tibial tendon dysfunction (PTTD)
is a condition that is a common cause of flatfoot. This condition is caused by changes in the posterior tibial tendon that weakens its ability to support the arch.
PTTD is the most common type of flatfoot developed during adulthood. In contract to the flexible flatfoot of childhood and adolescence, posterior tibial tendon dysfunction typically occurs in only one foot. However, some people may develop PTTD in both feet with one foot usually being more painful than the other. Similar to flexible flatfoot, PTTD is progressive condition, which will increase in severity over time. If PTTD is left untreated, the tendon will continue to deteriorate leading to possible tendon rupture and further deformity progression.
Symptoms of PTTD
- A visual flattening of the arch and an inward rolling of the ankle.
- Pain and varying amounts of swelling noted to the arch, inside portion of the ankle along the course of the tendon, and outside of the foot just below the ankle.
- Dull, achy arthritis type discomfort in the foot. In more severe cases, arthritis may also develop in the ankle.