Flat feet can be a perfectly normal trait for some people, but when the condition develops in adulthood and causes pain or changes in your gait, it could require treatment for adult acquired flatfoot deformity (AAFD). In some cases, surgery is the best option to restore function and relieve discomfort.
Understanding when surgery is necessary starts with knowing how AAFD develops, what symptoms to watch for, and how treatment typically progresses. If you’ve been diagnosed or you suspect you might have AAFD, exploring treatment options with our care team can help you feel confident moving forward.
What is Flatfoot?
Adult acquired flatfoot deformity is also known as progressive collapsing foot deformity and often simply referred to as flatfoot. It occurs when the arch of the foot collapses or flattens, causing the entire sole to come into contact with the ground.
This condition is most commonly caused by dysfunction of the posterior tibial tendon, which plays a key role in supporting the arch. When this tendon weakens over time, the arch can gradually fall, leading to changes in foot alignment and function.
What Are the Common Symptoms of Flatfoot?
Symptoms typically develop gradually and may worsen over time. As the condition progresses, the foot structure can shift, placing additional stress on joints and potentially leading to arthritis.
Common signs include:
- Pain along the inside of the foot or ankle
- Swelling or tenderness near the arch
- Flattening of the foot
- Ankle rolling inward
- Pain on the outside of the foot in later stages
- Difficulty standing on your toes or walking long distances
Non-Surgical Treatment Options for Flatfoot
In most cases, treatment begins with conservative (non-surgical) care, especially in the early stages. Many of our patients experience meaningful relief without surgery. These approaches aim to relieve symptoms and slow progression. In many early cases, they can be very effective.
Common non-surgical treatments include:
- Rest and activity modification to reduce strain
- Supportive footwear or custom orthotics to improve alignment
- Bracing to support the ankle and arch
- Physical therapy to strengthen the foot and improve flexibility
- Anti-inflammatory medications to reduce pain and swelling
When Surgery Might Be the Right Treatment
Our team will provide non-surgical treatments first. Surgery may be recommended when those measures no longer provide relief or when the deformity becomes more advanced.
The goal of surgery is to reduce your pain, restore alignment, and improve function. We typically consider this option to treat flatfoot if:
- Pain persists despite non-surgical treatment
- The condition continues to progress
- Your arch has significantly collapsed
- Walking and daily activities become difficult
- Your foot becomes stiff or develops arthritis
Types of Surgery for Flatfoot
Our team will tailor flatfoot surgery to your specific condition and treatment needs. We may consider a combination of procedures to correct the underlying problem.
Common surgical approaches include:
Tendon Repair or Transfer
If the posterior tibial tendon is damaged, it may be repaired or replaced with another tendon to restore support to the arch.
Osteotomy (Bone Realignment)
This involves cutting and repositioning bones to restore a more normal arch and improve foot alignment.
Ligament Repair or Reconstruction
Damaged ligaments that support the arch may be repaired to improve stability.
Joint Fusion (Arthrodesis)
In more advanced cases, joints may be fused to stabilize the foot and reduce pain, especially when arthritis is present.
Because flatfoot affects multiple structures in the foot, surgery often combines several techniques to achieve the best outcome.
Finding the Best Treatment for Flatfoot in Seattle
If you are experiencing foot or ankle pain, changes in your arch, or difficulty with daily activities, our care team can help determine the best treatment plan for you. Surgery to address the symptoms of AAFD or flatfoot is not the first step for most patients, but it can be an effective solution when other treatments aren’t enough. With the right evaluation and care plan, our patients typically experience significant relief and improved mobility.
If you have concerns about flatfoot or ongoing foot pain, a consultation with foot and ankle specialist Jonathan Hall, MD, FAAOS can help you understand your options and take the next step toward recovery. Contact our office today to learn more about treatment for flatfoot or other common conditions of the foot.