Flatfoot Treatment

�0b Treatment

Most children with flexible flatfoot (pes planus) do not need treatment. It is enough to have them wear comfortable shoes, and orthoses or special shoes are very rarely needed. Orthoses or special shoes may help only in special cases, such as when body weight is excessive and the flatfoot deformity is severe enough to cause calluses on the inner side of the foot and peeling skin, or when a child frequently sprains the foot due to tarsal coalition. There is no medical evidence for the claim that wearing orthoses, special shoes, or arch-support insoles early will correct flatfoot deformity. In general, it is difficult to distinguish this from the natural course in which the arch of a child’s foot normally becomes higher by around age 10 to 12.

1. Conservative treatment

If there are symptoms, arch-support insoles can be worn inside shoes. If the Achilles tendon is shortened, tendon stretching is needed, and although its effectiveness has not been proven, exercises such as walking on tiptoe or repeatedly doing toe-raise exercises to strengthen the posterior tibial muscle can also be tried.

2. Surgical treatment

If the deformity remains until after puberty but pain is mild, it is not a target for treatment. Surgical treatment is indicated when long-term conservative treatment has not been effective and daily life is limited due to pain, or when severe deformity makes the appearance of shoes look unusual. Flatfoot associated with neuromuscular disease, or cases accompanied by other conditions such as posterior tibial tendon dysfunction after adolescence, may require surgery. Surgical methods have been devised, including shortening a tendon on the inner side of the foot to correct the deformity, lengthening the heel bone, inserting an implant between the ankle bone and the heel bone, or fusing the joint. In addition, various surgical treatments are performed for the underlying diseases associated with rigid flatfoot.

Frequently Asked Questions

1. My child seems to have no inner arch. Does flatfoot need treatment?

When the human body grows normally, the inner arch does not appear during infancy. In most cases it starts to appear by ages 5 to 6, and in fact it often appears even later than that. Even if it is flatfoot, most cases are likely flexible flatfoot without symptoms, and if there are no symptoms, it is not a target for treatment, so it is better to observe until the child grows a little more.

2. Is flatfoot a military exemption?

Flatfoot also varies depending on severity. As shown in the criteria below, in very severe cases a class 5 rating may be assigned.

(Reference) Pes planus, valgus foot, varus foot, clubfoot, pes cavus, equinus, metatarsus, etc.

· Mild (no difficulty wearing standard socks and combat boots): Class 2

· Moderate or more severe (abnormal gait and difficulty wearing combat boots): Class 3

· If sequelae are present, judgment is made in the relevant category: Class 4

· In the case of rigid flatfoot with a contracted peroneus brevis (including cases that are not flexible flatfoot): Class 5

However, if you have flatfoot, foot fatigue comes on quickly, so military life is harder than it is for the general public. Therefore, getting appropriate treatment in advance before enlistment may be a wiser approach than hoping for a military exemption.

3. Does gaining weight cause flatfoot?

What is often described as becoming flatfooted from weight gain is, as can be seen in young children, a case in which there is simply a lot of soft tissue on the sole of the foot. In adolescents or adults, as body weight increases, the force that excessively collapses the foot inward also increases, which can lead to flatfoot symptoms, but it does not cause flatfoot itself.

4. What kind of shoes are good for flatfoot?

Recently, many functional shoes such as Masai shoes and cushioned shoes have been introduced. These functional shoes may help relieve flatfoot symptoms, but they do not fundamentally correct flatfoot. Therefore, it is more important to consult a specialist to understand the exact condition of the flatfoot.

So far, we have explained the treatment methods for flatfoot.

In the next part, we will look at metabolic syndrome.

Source: Korea Disease Control and Prevention Agency National Health Information Portal