Flat Feet Treatment in Los Angeles

What Are Flat Feet?

“Flat feet” is a term used to describe the lack of height in the inner arch compared to a normal arch. There are varying degrees of flatness, and not all flat feet are the same. Some arches are flexible and can be manipulated, while others are rigid and static. Not everyone with flat feet experiences pain or difficulty with movement. A child with flat feet will not necessarily develop problems later in life, and not all cases require treatment.

What Is Pronation?

Pronation describes the movement of the foot bones and arch while walking. During normal walking, the arch naturally lowers as the foot moves, a process called pronation. When excessive motion occurs at these joints, it is known as overpronation, which can cause foot fatigue and pain and contribute to ankle, knee, and hip problems.

The key components that influence the arch height and function include:

• The subtalar joint, located between the ankle bone and heel bone
• The talonavicular joint connects the ankle bone to the inside foot bone
• The calcaneocuboid joint links the heel bone to the outside foot bone
• The posterior tibial tendon supports the arch from the inside

It’s All Connected…

Signs and Symptoms of Flat Feet

Flat-foot symptoms vary based on severity, duration, and activity level. Patients may experience:

• Arch pain
• Arch fatigue
• Tendon pain (posterior tibial tendonitis)
• Outward-facing feet (out-toeing)
• Pain on the outer ankle (sinus tarsi syndrome)
• Heel rotated outward
• Loss of arch height
• Heel pain (plantar fasciitis)
• Bunions
• Foot arthritis
• Knee pain

Causes of Flat Feet

Genetics plays a major role in foot structure and arch development. Some individuals are born with a naturally lower arch, while others develop flat feet over time due to various internal and external factors, including:

• Obesity
• Ligamentous laxity
• Tight or short Achilles tendon (equinus)
• Forefoot varus (inward tilt of the ball of the foot)
• Excessive motion at the subtalar joint
• Congenital joint abnormalities (coalition)
• Misalignment between the rearfoot and midfoot joints
• Posterior tibial tendon dysfunction
• Overuse and sports injuries
• Poor footwear choices
• Heel fractures

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Diagnosing Flat Foot

Diagnosing flat feet requires a comprehensive evaluation to assess the structure, function, and alignment of the foot and ankle. Dr. Soomekh takes a detailed approach, incorporating the following diagnostic methods:

• Clinical examination: A hands-on assessment to evaluate foot structure and function
• Gait analysis: Observing movement patterns to assess how the foot performs while walking
• In-office digital X-rays: Providing detailed imaging of bone positioning and deformity severity
• 3D CT scan (if needed): Offering a precise view of joint alignment to guide treatment planning

How Are Adult Flat Feet Treated?

Conservative Treatment

For mild to moderate flat feet, non-surgical treatments focus on reducing excessive joint motion, alleviating fatigue, and relieving pain:

• Functional custom-molded orthotics: Support and correct foot alignment
• Braces: Provide additional support
• Physical therapy: Strengthens foot and ankle muscles
• Activity modification: Temporary rest to reduce strain

Surgical Treatment

For severe flat feet causing chronic pain and functional limitations, surgical reconstruction may be necessary. Flat foot surgery is a complex process that requires precise diagnosis, imaging, and individualized surgical planning. Dr. Soomekh selects the appropriate procedure(s) based on the patient's specific condition and goals.

Surgical procedures for flat foot correction include:

• Posterior tibial tendon repair
• Tendon transfers
• Achilles tendon lengthening
• Gastric recession
• Subtalar arthroereisis (implant stop)
• Calcaneal osteotomy (heel bone repositioning)
• Evans procedure
• Calcaneal slide
• Talonavicular fusion
• Medial column fusion
• Subtalar fusion
• Triple arthrodesis