Flatfoot Treatment: Orthotics or Surgery?


What is a flatfoot?

If we observe people walking, we will very often see the foot buckling inwards. Pronation, or the inward motion of the ankle and outward motion of the rest of the bones in the foot, is normal to the foot. Commonly known as “flatfoot,” hyperpronation is characterized by excessive pronation and causes an imbalance in the distribution of body weight. Hyperpronation can be accompanied by pain and swelling in the foot or ankle and, in time, can cause further damage to joints, ligaments, and even the bones of the foot.

In most people, a slight flatfoot deformity is very common and usually absolutely harmless. Particularly in children, flat feet are not considered a pathological deformity.


Conservative Hyperpronation Treatment

Early hyperpronation or beginning flexible flatfoot can effectively be treated with insoles and physiotherapy. Podologic insoles can be used to treat hyperpronation at its early onset, in the treatment of beginning flexible flatfoot deformity. Podologic insoles correct the deformity by stimulating the muscles. With the help of physiotherapy and the insoles, the foot and lower leg muscles are strengthened, which enables them to absorb the load of the body when walking. Exercises during physiotherapy are designed to focus on and strengthen the muscles that stabilize the longitudinal arch of the foot, thus stabilizing the position of the foot.


Surgical Treatment of Hyperpronation

In an advanced stage of flatfoot deformity, a significant lowering of the longitudinal arch of the foot can be observed. Unlike hyperpronation, or beginning flexible flatfoot, the individual may no longer raise the longitudinal arch of the foot with the help of their own muscle force. At this advanced stage, the flatfoot usually causes significant swelling and pain in the ankle area.

In the acute stage, insoles provide pain relieve and more comfort. However, long term, corrective foot surgery may be needed. During an operation, the axis of the rear foot is corrected. The result is an almost normal appearance of the foot.

The results of a surgical intervention are promising, as the deformity is corrected and the function of the foot restored (can’t flat feet people walk; isn’t the function of the foot to walk?).

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