Flatfoot Treatment
Flatfoot (Pes Planus) Treatment
Our feet are engineering marvels that bear the entire weight of our body and give us freedom of movement. The arch of the foot, one of the fundamental building blocks of this structure, may not be at its normal height in some individuals due to congenital or acquired causes. This condition, known as “Flatfoot” or, in medical terminology, “Pes Planus,” can become an orthopedic problem requiring treatment, particularly when it leads to pain, fatigue, and postural disorders. As Prof. Dr. Murat Bozkurt, in our clinic we apply the most up-to-date, personalized flatfoot treatment methods for both our pediatric and adult patients.
What Is Flatfoot (Pes Planus)?
Flatfoot is a condition in which the longitudinal arch that should be present on the inner side of the foot collapses or fails to develop at all. In this case, the entire sole of the foot touches the ground when the person is standing or walking. Flatfoot can be a condition frequently seen in childhood, usually of the flexible type, but it can also develop in adulthood for various reasons.
Types of Flatfoot
We generally examine flatfoot under two main categories. Making this distinction is critical for creating the correct treatment plan:
Flexible Flatfoot: This is the most common type. The arch of the foot is visible when the person is sitting or lifting the foot off the ground, but disappears when standing and bearing body weight. It is usually seen in childhood, and in most cases it resolves as the child grows older.
Rigid Flatfoot: A rarer condition that may indicate an underlying bony problem. In this type, the arch of the foot is absent even when the patient is not standing. It can be painful and must always be evaluated by an orthopedic specialist.
Symptoms of Flatfoot: When Should You See a Doctor?
Not every case of flatfoot requires treatment. However, if one or more of the following symptoms are present, it is important to consult a specialist:
Pain: Pain and cramps in the foot, ankle, or legs, especially increasing after activity.
Rapid Fatigue: A feeling of quickly tiring during walking or sports.
Balance Problems: Clumsiness or instability while walking or running.
Abnormal Shoe Wear: The inner edges of shoes wearing down faster and disproportionately.
Inward Rolling: The heels tilting outward and the feet rolling inward while walking.
Swelling: Swelling on the inner side of the feet or in the ankle.
Diagnosis and Evaluation Process
The road to correct treatment begins with a correct diagnosis. In our clinic, we follow these steps to diagnose flatfoot:
Detailed Physical Examination: We evaluate the structure of your feet, your posture, and your foot arch both while lying down and while standing.
Gait Analysis: We observe your walking pattern to examine the movement mechanics of your feet and any gait abnormalities.
Imaging Methods: When necessary, X-rays are requested to examine the bone structure in detail. If we particularly suspect rigid flatfoot or another underlying problem, we may resort to advanced imaging such as MRI or Computed Tomography (CT).
Personalized Flatfoot Treatment Methods
Our goal in treatment is to eliminate pain, improve function, and prevent the condition from progressing. The treatment plan is created entirely on an individual basis, depending on the patient’s age, the severity of their complaints, and the type of flatfoot.
Non-Surgical Treatments
The vast majority of patients are successfully treated with non-surgical, conservative methods:
Observation and Follow-up: Regular follow-up at certain intervals may be sufficient, especially for children with asymptomatic, flexible flatfoot.
Custom Orthopedic Insoles: One of the most effective methods for supporting the foot arch, distributing pressure evenly, and reducing pain. Insoles custom-made for the individual’s foot structure and gait pattern both improve comfort and correct walking mechanics.
Physical Therapy and Exercises: Special exercise programs are designed to strengthen the foot and leg muscles and to stretch the Achilles tendon, which is often tight. This process yields the best results when carried out with the guidance of an experienced physiotherapist.
Proper Footwear Selection: Shoes that provide good arch support, have a firm heel counter, and a wide toe box should be preferred.
Activity Modification: Patients may be directed toward activities such as swimming instead of high-impact sports that trigger pain.
Surgical Treatment
Surgical treatment becomes an option for patients who do not respond to non-surgical treatments, who have severe pain, and whose quality of life is significantly affected. Flatfoot surgery may involve a series of procedures tailored to the patient’s needs, rather than a single procedure:
Tendon Repair or Transfer: Usually performed in adults, applied in cases related to dysfunction of the posterior tibial tendon.
Bone Realignment (Osteotomies): Cutting the foot and heel bones to reposition and fix them in the correct alignment.
Joint Fusion (Arthrodesis): The permanent fusion of severely deformed and painful joints.
With an accurate diagnosis and a treatment plan tailored specifically to you, it is possible to relieve the complaints caused by flatfoot and improve your quality of life once again.
If you or your child are experiencing symptoms of flatfoot, it is important to consult a specialist without delaying the issue. You can contact us for a detailed evaluation and to create the most suitable treatment roadmap for you.
Frequently Asked Questions
My child has flatfoot, should I be worried? Will it improve as they grow?
Flexible flatfoot seen in childhood is quite common, and in most cases it resolves on its own toward adolescence as the foot muscles and ligaments strengthen. If your child has no symptoms such as pain, quick fatigue, difficulty walking, or inward rolling, it is generally not a cause for concern and follow-up alone is sufficient. However, if such complaints are present, it is important for the child to be examined by an orthopedic specialist to determine whether there is an underlying problem and to ensure proper guidance.
Do the custom insoles used in flatfoot treatment really work?
Yes, especially in painful cases of flatfoot, custom-made orthopedic insoles are one of the most effective and fundamental steps of treatment. Unlike off-the-shelf products, these insoles are designed based on the patient’s foot structure and gait analysis. By supporting the foot arch at the correct point, they ensure that body weight is distributed evenly across the sole, reduce pain and fatigue, and improve walking comfort.
Does every case of flatfoot require surgery?
No, it definitely does not. The vast majority of flatfoot cases are successfully treated with non-surgical (conservative) methods. Surgery is an option only for a small number of patients—particularly those with rigid flatfoot—who do not respond to treatments such as insoles, exercise, and shoe modification, and who have severe pain and deformity that significantly reduce their daily quality of life.
Are flatfoot exercises alone a sufficient treatment?
Flatfoot exercises play a very important and supportive role in treatment, but on their own they are usually not sufficient. These exercises aim to strengthen the muscles that support the foot arch, stretch the tight Achilles tendon, and improve the overall flexibility of the foot. The best results are achieved when exercises are combined with other methods, such as the use of custom insoles and proper footwear selection.
What type of shoes should I choose for flatfoot?
Footwear selection plays a critical role in managing complaints related to flatfoot. When buying shoes, you should pay attention to the following features:
Good arch support: There should be a structure on the inner side of the shoe that supports the foot arch.
Firm heel counter: It should hold your heel firmly in place, preventing it from rolling inward or outward.
Wide toe box: It should provide enough space for your toes to move comfortably.
Sturdy yet flexible sole: The sole should not be too soft; it should be able to flex during walking but should not fold easily. It is generally best to avoid flat, ballet-flat style, overly soft-soled, or unsupportive athletic shoes.