Dear Doctor:

I want to exercise more often, but I have flatfeet and occasional pain.  How can I get active again while not hurting my feet?

Dear Reader:

Flatfeet can be a difficult problem to have, however, many treatment options are available. Treatments can range from the conservative to surgical with the first line of treatment focused on conservative treatment.

The first step in the treatment of a flatfoot is diagnosing how severe the flatfoot is, and what component of the flatfoot is causing the pain.  It is best to have the foot and ankle evaluated and x-rays taken. This will allow for the evaluation of the severity, any arthritis that may be occurring, and extra bones that can exist.

The first line in the treatment of the flatfoot and prevention of any pain or further pain is the use of an orthotic.  An orthotic can help to change how the foot functions (functional orthotic) or can accommodate and pad the foot (accommodative).  The orthotic will control how the foot strikes the ground, absorbs shock, and reduces stress in the foot.  It can aid in the treatment of pain within the flatfoot, but also prevent further tendon damage and even slow the progression of arthritis.  Orthotics can and should be worn in most shoes and sneakers. It is recommended that these are used when exercising, working, or any other activities that require a length of time on the feet. Custom orthotics can be made which are individualized to your specific foot.  Over the counter orthotics can also be worn, however, consult your foot and ankle specialist first as there are pairs much more superior to others.

Should pain increase or not subside, treatment is focused on immobilization of the foot with a walking fracture boot and anti-inflammation. Stretching the Achilles tendon and posterior muscle group will also be instituted into the treatment. A tight Achilles tendon can cause the flatfoot to become more severe. Stretching will not correct the flatfoot, but can prevent the progression of the deformity. Once the pain has decreased, the orthotics will again be worn and activity resumed.

Surgical treatment of the flatfoot is the last option and is reserved when conservative measures have failed.

I hope that this information is helpful.

Peter Stasko, DPM, a fellowship trained foot and ankle surgeon, earned his medical degree at Des Moines University College of Podiatric Medicine and Surgery, and completed a three-year foot and ankle residency program at the top ranked Western Pennsylvania Hospital in Pittsburgh. He also completed a foot and ankle fellowship at the Mon Valley Foot and Ankle Reconstructive Fellowship in Pittsburgh. Dr. Stasko sees patients at Finger Lakes Bone and Joint in Newark and Geneva and performs surgeries at Newark-Wayne Community Hospital.