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Dallas Podiatry Works

Conservative Treatments for Flatfoot Pain

Dr. David R. Northcutt
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Dr. David Northcutt is a podiatrist and foot and ankle surgeon at Dallas Podiatry Works in TX.

"Hi, I’m Dr. Northcutt and I want to talk a little bit today about adult acquired flatfoot deformities. This is a deformity which is associated with the posterior tibial tendon and its dysfunction. Posterior tibial dysfunction is a condition caused by changes in the tendon which result in difficulty supporting the arch of the foot. This results in a slow flattening of the foot over time. Posterior tibial tendon dysfunction is usually progressive, which means it will keep getting worse, particularly if it isn’t treated early.

Symptoms usually occur after activities that involve significant use of the tendon, such as running, walking, hiking, or climbing stairs. Symptoms may include pain, swelling, and flattening of the arch, and an inward rolling of the ankle. Pain typically starts on the inside part of the foot or ankle, which is where the tendon is located. As the arch flattens, you may notice the foot turn outward and the appearance of the ankle rolling inward. As the deformity progresses, pain may begin to the outer portion of the foot and ankle. At this point the tendon has typically deteriorated considerably and arthritis has started to develop in joints of the foot.

Treatment is usually better when addressed early. Treatment can include custom orthotics, braces such as these, and also a period of non-weight bearing or immobilization, and sometimes a below-the-knee boot. Anti-inflammatories can also be helpful. Shoe modifications may be needed. Physical therapy also sometimes can be of benefit. Occasionally surgery is needed. These are typically reserved for advanced cases or cases where the pain is not controlled to a tolerable level. If you have any pain similar to what has been described, our team at Dallas Podiatry Works will work with you to determine the proper treatment and help you keep active. All of us here at Dallas Podiatry Works would love to be a part of your healthcare team."