Flat Foot Deformity
Flat feet or flat foot disorders can be categorized into two groups, congenital (pediatric) and adult acquired. Congenital (pediatric) flat feet are not rare but may draw attention when a child, begins complaining of foot, ankle or knee pain, often while participating in sport and exercise. More common to the world of physical therapy and sports medicine is the adult acquired form of flat feet. This change in foot appearance is often the result of a chronic dysfunction of the posterior tibial tendon which is designed to maintain or “lift” the arch during activity. Over time, this tendon begins to stretch out and then it loses the ability to maintain proper arch height. Loss of arch may also be due to ligament (soft tissue) injury, arthritis or preexisting foot structure. The gradual loss in arch height is not often noticed until pain limits exercise and daily activities. While formal diagnosis requires an orthopedic or podiatry expert, a good clue is when one foot becomes painful and lacks the same arch height or turns out more than the non-painful foot. If symptomatic, this form of flat foot deformity can be treated conservatively with activity modifications, orthotics and physical therapy. Though conservative measures often result in good reductions in pain and return of function, restoring the arch height does not occur with this treatment approach. If conservative treatment is not effective, surgical options are available to relieve pain and restore function.
Bunion
A bunion, also known as hallux valgus, is a bony deformity of the big toe where the base of the big toe joint begins deviating inward with the toe deviating towards and crowding the other toes. Like adult acquired flat foot deformity, a bunion is a gradual process that goes unnoticed for a time until toe crowding or pain becomes more obvious. A bunion may become bothersome with pain at the medial eminence (bump), especially when wearing shoes, when rubbing toes together or when there is pain at the ball of the foot. While a bunion may be significant, treatment is based on a patient’s symptoms. Initial conservative management is on shoewear and activity modification. Wider shoes or sandals can often alleviate many symptoms. When conservative management is not successful, surgical management is based on patient symptoms and deformity. While bunions are common causes of pain, there are several other diagnoses that may lead to symptoms. If you are concerned about a bothersome bunion, clinical assessment and x-rays are warranted to determine the source of pain and appropriate treatments.
Hammertoes
Hammertoes are defined by a deformity of one or more of the joints of the toe resultant from chronic shortening or tightening of a muscle and tendon. The second toe is the most prone to developing this condition and is often caused by genetics, gait patterns, medical conditions such as diabetes, a long second toe, flat feet, or improper shoe gear. Again, hammertoes are diagnosed by visual changes to the toe(s) in relation to the surrounding toes. Fortunately, there are many hammertoe treatment options ranging from simple changes to footwear to surgical correction. Correct footwear, orthotic inserts, and physical therapy are often the first treatment options with good success.
Summary
Changes to the foot are a common occurrence and increase in likelihood as we age. Often these changes can result in pain and activity limitation, such as sports, exercise or even getting around the grocery store. When you are concerned about foot pain, function and/or shape, it is important to be assessed by an orthopedic and podiatry expert specializing in foot and ankle diagnosis and treatment. Conservative management should be the first line of treatment and often results in favorable outcomes. This may include proper supportive footwear for your condition, orthotics, and/or physical therapy. Consult the orthopedic experts at OSMI if you are experiencing any of these common foot deformities and would like an evaluation.
Our goal at the Orthopedic and Sports Medicine Institute (OSMI) is to provide our patients quality, cutting-edge orthopedic treatments, both surgical and non-surgical. If you have questions about flat foot deformities, bunions, or hammertoes, please submit an online appointment request or contact our office at 817-529-1900.
