What is it?
Adult flat foot develops when the arch gradually collapses. The most common cause is weakening of the tibialis posterior tendon, which runs behind the inner ankle bone and supports the arch.
What causes it?
- Wear and weakening of the tibialis posterior tendon.
- Age, being overweight, diabetes and high blood pressure.
- Inflammatory arthritis.
- Previous injury.
Common symptoms
- Pain and swelling on the inner side of the ankle.
- The arch flattening and the toes pointing outwards.
- In later stages, pain on the outer side of the ankle.
- Difficulty standing on tiptoe, and tiredness when walking.
How is it diagnosed?
Your surgeon will examine the foot standing and test whether you can rise onto tiptoe on one leg. X-rays taken while standing are used, and an MRI or ultrasound scan shows the tendon.
Things you can do now
- Wear supportive shoes with good arch support
- Try off-the-shelf arch support insoles
- Keep your weight in a healthy range
- Avoid long walks on uneven ground while it is painful
Treatment
Treatment is tailored to your individual needs, symptoms and goals. Depending on your situation, it may include supportive footwear, insoles, an ankle brace, physiotherapy, pain relief, reconstructive surgery, including tendon transfers and realigning the bones and fusion for advanced, stiff deformity.
Mr Jeyaseelan will talk you through the options that are right for you at your consultation.
When to see a specialist
- One foot is flattening or changing shape over time
- There is pain or swelling on the inside of the ankle
- You struggle to stand on tiptoe on one leg
What to expect
Caught early, many people do well with insoles, a brace and physiotherapy. If the foot continues to collapse, reconstruction can restore its shape and relieve pain.
Common questions
Where can I see a specialist about adult flat foot (progressive collapsing foot deformity) in London?
Mr Lucky Jeyaseelan, a consultant orthopaedic surgeon who specialises only in the foot and ankle, sees private and insured patients with adult flat foot (progressive collapsing foot deformity) at Align Orthopaedics on Harley Street, The London Clinic on Devonshire Place, HCA London Bridge Hospital, HCA UK at The Shard, HCA UK City of London on Old Broad Street and The Holly Hospital in Buckhurst Hill, Essex. See all clinic locations or request an appointment.
Do I need a GP referral?
Self-funding patients can book directly, though a GP letter is helpful. Most insurers need a GP referral before they authorise your consultation, so check with yours first.
This information is general and is not a substitute for a medical consultation. Your diagnosis and treatment plan will be tailored to you.