Do all Flat Feet Need Surgery?

Studies suggest 20-30 percent of all people suffer from flat feet. Duck feet, as some may call it, is medically describes as pes planus. Though flatfoot is a well recognized diagnosis, its cause is not as well defined. Flatfoot can be seen in young children and is actually considered normal up to the age of two or even five years old. Some flatfoot conditions occur much later in life and in reality; flatfoot can be encountered at any age and cause a broad range of pain from absolutely none to physically debilitating.

The most basic way to describe a flatfoot is rigid or flexible. A rigid flatfoot is flat all the time. Whether standing or sitting, the foot never appears to have an arch. A flexible flatfoot on the other hand looks and appears normal when non-weight bearing but as soon as one stands up the arch disappears and the foot collapses to the floor. Generally, those with a rigid flat foot experience more pain. Those with flexible flatfoot have a wider range of discomfort. Some experience no discomfort at all.

Whether experiencing pain or not, the general public and many of patients are quite concerned about their flatfeet. As if the flatfoot is a ticking time bomb that will ruin their life, everyone wants to know what they can do for their flat feet! There is truth to when your feet hurt your whole body hurts, but often, the trick to keep your feet happy is not taking them under the knife. With that said, there are a considerable number of people who benefit greatly from surgical reconstruction of their foot. These people have exhausted all conservative treatments that have all failed to bring them relief.

Where to start? If you are asymptomatic, don’t worry so much. There is nothing you can do short of surgery that will recreate an arch. When you have a flatfoot, it is often a combination of soft tissue failure and boney alignment dysfunction. The biomechanics of your foot becomes compromised. You can still walk but for some, it is not without discomfort. Simple measures such as orthotics and bracing are often all that is needed to rid the discomfort. This also means that shoes play an important role. Every day of the summer I have patients strolling into my office in flip flops and other poor excuses for shoes. Low and behold, this only creates problems for flatfooters.

Parents often get very anxious when they see their child flopping around on archless feet. Studies have shown that athletic performance or injury rates have zero correlation to flat feet. If the flat feet are asymptomatic, no treatment is eminent through research is lacking to really determine the value of an orthotic on long term symptoms. For children that have symptoms, they may have an underlying coalition, meaning they may have bones in their foot that are fused that shouldn’t be. These children improve significantly with surgical procedures to correct this deformity.

Generally, my rule of thumb is pain needs to be treated and concerns of your health should always be addressed. Flatfoot does not mean you need a complex surgery. Though surgical procedures for flatfoot can greatly improve one’s symptoms it is not for everyone.


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