Adult Flat Foot
Flat feet or pes planus can be acquired or congenital. Many adults with flat feet have acquired the deformity over time. It occurs through a progressive dysfunction of a major tendon in the foot called the posterior tibial tendon. This tendon serves as the major force in keeping your arch up. However, in time and through deforming forces such as tight Achilles' tendon and weight/pressure with activity, the posterior tibial tendon starts to lose its function and integrity. Your body then compensates for the lack of posterior tibial tendon function by shifting some major rear foot joints out of alignment, swinging your foot out, and even bringing your knees together for stability.
If you have pain associated with your flat foot, there are surgical as well as nonsurgical treatment plans to make you more comfortable and functional. I always discuss nonsurgical treatment options with my patients such as custom orthotics, ankle braces, even cast immobilization in the early stages of tendon pain. However, by the time most of my patients present to my office they are already in the later stages of the deformity and surgery is usually discussed in the form of either bone cuts with tendon repairs or fusions of the major joints in the rear foot. The postoperative course is usually 8-10 weeks of no weight at all on the operative foot followed by weight-bearing in a post-op boot for another month, after which my goal is to get my patient doing even more activity than they were able to tolerate without pain before the surgery.