Q&A Topic: Feet That Go Flat

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Kurt Voellmicke, MD, FAAOS

Q. I have an ongoing pain on the side of my ankle. I was told that it might be adult-acquired flat foot. What is it and how can I tell if that is the condition I have?

A. There are aspects of getting older that are simply no fun. For example: In some people—mainly women over 40—the feet will just give out. More specifically, they get adult-acquired flat foot. (Men get it too, by the way.) People usually recognize something’s wrong when they start to experience pain on the inner side of the ankle. This is inflammation of the posterior tibial tendon, which supports the arch. As the tendon weakens, it can tear and the arch can actually collapse.

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Q. Are there certain factors that increase the risk of getting adult-acquired flat foot?

A. Women who have flat feet or low arches to begin with, and are carrying some extra weight, are at highest risk. If you experience pain in your ankle or arch, you should seek treatment.

Q. What can I do to relieve the pain?

A. Whether you’ve had the pain for a while or it has just started, there are strategies that can help. First, you need to rest and immobilize the foot. Icing the area and taking anti-inflammatory drugs will help ease the pain. Once the inflammation decreases, you can use a walking boot to get around; eventually, you can be fitted with a custom orthotic shoe insert to take stress off the tendon.

Q. What happens if my pain continues?

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A. Many patients will recover using these measures. But some patients will need surgery. If your pain persists through initial treatment, a surgeon can go into the ankle and transfer a neighboring tendon to handle the load of the damaged or weakened one. In addition, a surgeon can manipulate the bones in the foot to recreate the arch and help alleviate stress on the tendon.

Q. I’ve never heard of adult-acquired flat foot. Is this a common condition?

A. You’re certainly not suffering alone. This is a very common foot problem. Medically speaking, the causes are multifactorial.  Whether due to genetics or anatomic structure, some people are predisposed to get it. Make sure you address flat feet as soon as you feel symptoms. Don’t let it smolder too long. Walking on a painful ankle for months and months is a bad idea.

Northern Westchester Hospital
Director, Foot and Ankle Section
Orthopedic and Spine Institute

Learn More About Dr. Voellmicke

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More from Dr. Voellmicke:
Ankle Sprains

Northern Westchester Hospital is a proud member of Northwell Health (formerly North Shore-LIJ Health System).

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