How is a Flatfoot Diagnosed?

Does a low arch in the foot mean that you have flatfoot? How do you diagnose a flatfoot, and when is a flatfoot a problem?

What causes flatfoot?

There are many causes of flatfoot. One of the most common is tendonitis of the posterior tibial tendon. This typically occurs overtime with use. This tendon helps control your arch. If it becomes inflamed and tears, your arch can fall. 

Risk factors for symptomatic flatfeet:

• Genetics (born with a flatfoot)
• Obesity
• Women over 50 years old
• Diabetes
• Rheumatoid arthritis 

Do I have flatfeet? How do you diagnose a flatfoot?

The orthopedic surgeons at Southwest Orthopedic Group can help determine if you have a flatfoot with a clinical exam and x-rays. 

A lot of patients can tell if they have flatfeet by just looking. The easiest angle to check for flatfeet is by looking at the back of the feet.

However, orthopedic surgeons use a thorough physical exam to diagnose flatfeet. Orthopedic surgeons will evaluate your feet while sitting and standing, and they will compare both feet to observe any differences. Additionally, surgeons may evaluate how you walk and if you can rise onto your toes. 

Additionally, x-rays of your foot and ankle help make the diagnosis. Sometimes advanced imaging, such as an MRI, is needed to further evaluate the posterior tibial tendon and ligaments.

What are the stages of a flatfoot?

There are many stages of a flatfoot. Patients can progress through the stages or stay at one stage. A goal is to initiate treatment prior to reaching advanced stages. 

The stages of flatfoot include:

1. Tendonitis of the posterior tibial tendon
2. Flatfoot deformity 
3. Rigid deformity (arthritis in the hindfoot)
4. Ankle pain and/or deformity

Will my flatfoot get worse overtime?

Some flatfeet can get worse as people get older. However, we cannot predict which flatfeet will stay stable and which deformities will worsen. Surgery isn’t generally recommended based on a concern the deformity will get worse. 

Can flatfeet cause plantar fasciitis?

Yes! Patients with flatfeet can get tightness in the plantar fascia and Achilles, which can lead to plantar fasciitis. 

Can flatfeet cause ankle pain?

Yes! In more advanced flatfeet or in chronic flatfeet, the ankle can be affected. The foot is the foundation of your ankle. When the foot starts to tilt, as in flatfoot, the ankle can follow. This can occur years after initially developing a flatfoot. 

See our previous post regarding the anatomy of a flatfoot.

The American Orthopaedic Foot & Ankle Society (AOFAS) has more information about Achilles tendon tears at FootCareMD.

For more questions or to set up an evaluation, contact Dr. Stautberg’s office at 281-977-4870. 

Author

Eugene Stautberg, MD