Posted by Jenn F. on Tuesday, July 10th, 2012
Yesterday we talked about flat feet and what causes them. If your flat foot condition hasn’t progressed too far, you may be able to manage with orthotics and braces. If your arches have collapsed completely, however, you can be at risk for developing arthritis in your heels and become vulnerable to other ancillary issues like lower back problems–in addition to the daily pain and fatigue you feel from walking and standing on flat feet. If your flat feet are causing you that much trouble, surgery may be the best option.
There are several procedures for reconstructing flat feet. A podiatrist at The Center for Podiatric Care and Sports Medicine (212.996.1900) can examine your feet and determine which procedure is best for you; actually, several are often done at the same time (and hopefully all are covered by your health insurance!).
Here are some common procedures a podiatrist may perform to help your flat feet.
Gastrocnemius Recession This is the extremely fancy, official terms for something rather uncomplicated: lengthening the calf muscle. People with flat feet may develop tight calf muscles from adjusting the way they walk; tight calf muscles can then contribute to any number of other foot problems, for example plantar fasciitis. Lengthening the calf muscle allows the foot to rest more naturally. This procedure would typically be done with other surgeries.
Tenosynovectomy This is a procedure that can be done when adult onset flat feet are in a very early stage. Inflammation around the posterior tibial tendon can cause it to fray and eventually tear, leading to fallen arches. A tenosynovectomy cleans out the synovium, or inflamed tissue surrounding the tendon. This is relatively simple, however, it only deals with the symptoms; it doesn’t address what was causing the tissue to become inflamed, and a tendon that already has some tears in it may still rupture.
Tendon Replacement In this procedure, a new tendon is attached to the old, torn one. The new tendon may come from one of your toes. After surgery, a person may still have some trouble running or performing athletic activities, but it varies from person to person.
Osteotomy Here bones are cut and shifted, usually in the heel bone, to help rebuild the shape of the arch. Sometimes it may be necessary to fuse the bones together, using screws or plates to hold the bones in place while they heal together. Bone grafts may be required if the foot needs to be lengthened. This New York Times article about a patient’s experience having surgery for flat feet has a great description of an osteotomy.
Joint Fusion In cases where flat foot is very far advanced, arthritis may be present and the foot isn’t flexible enough to try procedures like a tendon replacement or an osteotomy. When that happens, it might be best to fuse the bones of the ankle joint together. The arthritic joint is removed and the foot is able to be realigned. There may be some loss of mobility, but the arthritis present before the surgery probably created more difficulty in walking, so it may actually feel like there’s been a little improvement.
Of course the best thing to do is catch any foot condition like adult onset flat feet early so you can avoid surgery. If you suspect you may have this condition or any other foot or ankle problems, contact The Center for Podiatric Care and Sports Medicine. Dr. Josef J. Geldwert, Dr. Katherine Lai, and Dr. Ryan Minara have helped thousands of people get back on their feet.
If you have any foot problems or pain, contact The Center for Podiatric Care and Sports Medicine. Dr. Josef J. Geldwert, Dr. Katherine Lai, and Dr. Ryan Minara have helped thousands of people get back on their feet. Unfortunately, we cannot give diagnoses or treatment advice online. Please make an appointment to see us if you live in the NY metropolitan area or seek out a podiatrist in your area.