It’s been busy here for my NYC podiatry patients, but there is always time to save some more lives. And in this case it’s by treating the societal scourge of…flatfoot. And before anyone starts making the obvious law enforcement jokes, let’s have at it with the treatments.

As has been previously mentioned, flatfoot is not a problem unless it’s a problem, much like many other of life’s problems. And when it’s a problem it generally manifests as pain. This is due to the strain on bone and soft tissue structures that are unable to support the body weight and partially or totally collapse. You’ve seen these feet before- the arch is flat as a pancake and the heel bone may even be tilting outward. As this happens the ankle turns down toward the other leg, placing undue stress not only on the foot, but the leg, knee, hip and back. Needless to say this is a very inefficient construct for standing, walking, and running. Over time, the tendons that are overworking in attempting to support the foot and leg fray and lose all ability to support the weight of the foot and leg, and the bones and joints may develop arthritis and other adaptive changes. Of course there are varying degrees of flatfoot, and the worst looking flatfoot may in fact be symptomatic which a very mild collapse of the arch may manifest as debilitating pain.

So what to do? The initial treatment, of course, is the use of custom orthotics, which we have discussed many times before in this most holy and world famous blog. Orthotics are custom shoe insoles that can be designed for an individual patient and act to support the foot and maintain it in a biomechanically ideal position. As a foot dude, it is quite gratifying to witness a patient who presents to the office with a lifetime history of lower extremity of pain, and with the addition of a simple custom insole is liberated and transformed into a pain free walking and running machine. And in most cases, the transformation can indeed be dramatic, and as I tell my male patients, they even become more attractive to the ladies- guaranteed. Well, ok, maybe not guaranteed, but it doesn’t take a foot doc to know that adding support to an unsupported foot is a good thing. So what to do if that doesn’t work? Tune in for next week’s action packed blog…

See in you in the office.

Ernest Isaacson