Adult Flatfoot (Pes Planus) Treatment Miami, FL
Adult Flatfoot (Pes Planus)
Adult flatfoot, also called fallen arches or pes planus, is a condition in which the arch of the foot collapses, causing the entire sole to touch the ground. While many adults may have flexible flatfoot without pain, some experience discomfort, fatigue, and progressive deformity that can affect walking, running, and overall mobility.
Flatfoot in adults can be flexible or rigid:
- Flexible flatfoot: The arch may appear when standing on tiptoes or during non-weight- bearing activities; pain is often minimal.
- Rigid flatfoot: The arch remains flattened at all times, often causing pain, swelling, difficulty wearing shoes, and long-term joint stress.
Causes and Risk Factors
Adult flatfoot is most commonly caused by:
- Posterior tibial tendon dysfunction (PTTD): Weakening or tearing of the tendon that supports the arch
- Ligament laxity: Loose or stretched ligaments that fail to maintain foot alignment
- Trauma: Fractures or injuries that alter foot structure
- Degenerative changes: Arthritis or other age-related joint changes
- Genetics: Family history of flatfoot or low arches
Unlike pediatric flatfoot, adult flatfoot often develops over time rather than being present from birth.
Signs and Symptoms
Adults with flatfoot may notice:
- Flattened arch with heel tilting outward
- Pain along the inner side of the foot or ankle
- Swelling along the posterior tibial tendon
- Difficulty standing or walking for long periods
- Changes in gait, causing strain in knees, hips, or lower back
- Foot fatigue and aching with activity
Diagnosis
Dr. Alejandro Pino evaluates adult flatfoot through a combination of:
- Physical examination: Observing foot alignment, flexibility, and tendon function
- Imaging studies: X-rays, CT, or MRI to assess bone structure, joint degeneration, and tendon integrity
- Functional assessment: Evaluating gait and load distribution to determine biomechanical impact
Accurate diagnosis is essential to determine the most effective treatment and prevent progression.
Treatment
Treatment of adult flatfoot depends on the severity, flexibility, and associated pain.
Conservative Management:
- Activity modification to reduce strain on the arch
- Orthotics or custom shoe inserts to support the arch
- Physical therapy to strengthen the posterior tibial tendon and surrounding muscles
- Anti-inflammatory medications for pain and swelling
- Proper supportive footwear to reduce discomfort
Surgical Management:
Surgery may be recommended for adults with persistent pain, deformity progression, or tendon dysfunction that does not respond to conservative care. Surgical options include:
- Tendon repair or transfer to restore arch support
- Osteotomy or bone realignment procedures to correct deformity
- Joint fusion (arthrodesis) for severe arthritis or rigid deformity
- Implant placement in select cases to restore foot mechanics
Dr. Pino tailors surgical planning to each patient's anatomy and activity level, aiming to restore alignment, reduce pain, and maintain long-term foot function.
Why Choose Alejandro Pino, MD for Adult Flatfoot?
Dr. Alejandro Pino is a fellowship-trained orthopedic foot and ankle surgeon specializing in adult flatfoot and complex deformities. His approach emphasizes:
- Careful evaluation of tendon, ligament, and joint health
- Individualized treatment plans based on anatomy, activity, and symptoms
- Preference for conservative care when appropriate, with surgical intervention reserved for persistent or severe cases
- Precision surgical techniques aimed at restoring alignment, mobility, and long-term joint preservation
- Clear guidance on recovery, rehabilitation, and activity modification
Patients choose Dr. Pino because he combines advanced surgical expertise with personalized care, ensuring both pain relief and functional improvement.
