Serving Southwest Michigan since 1978

Flatfoot Treatment and Surgery in Kalamazoo, MI

Arch support first. Surgery when it’s needed. Modern treatment for fallen arches, adult-acquired flatfoot, and the inner-ankle pain that comes with a collapsing arch.

Same-week appointmentsMost insurance acceptedX-rays on site
The five board-certified foot and ankle surgeons of Kalamazoo Foot Surgery in Kalamazoo, MI
5
Board-Certified Foot & Ankle Surgeons
1978
Caring for Kalamazoo Since
3
Hospital Affiliations
7
Non-Surgical Options We Try First

What Is Flatfoot?

Flatfoot (also called fallen arches or pes planus) is when the arch on the inside of your foot is low or gone, so most of the sole touches the ground when you stand. Some people are born with flat feet and never have pain. Others develop a flat arch over time as the tendons and ligaments that hold the arch up stretch out or wear down. That second kind, adult-acquired flatfoot, is the one that tends to cause trouble.

The arch is held up mostly by a tendon on the inside of your ankle, the posterior tibial tendon. When that tendon is overloaded, injured, or weakened, the arch slowly drops. As it does, the foot rolls inward, the heel tilts out, and the front of the foot points away from the body. This is why flatfoot pain often starts on the inside of the ankle and later moves to the outside of the foot. Caught early, a falling arch can usually be supported and stabilized. Left alone, it tends to get worse, and the bones and joints can stiffen into a fixed flat position.

Weight-bearing side-view X-ray used to check whether the arch is collapsing in flatfoot

Types of Flatfoot

The cause and whether the arch can still move both change the treatment plan. These are the forms we most often treat.

Flexible Flatfoot

The most common type, and the most treatable. The arch flattens when you stand but reappears when you sit or rise onto your toes. Many people have flexible flat feet with no pain at all, and when it does hurt it usually responds well to support.

Adult-Acquired Flatfoot

A once-normal arch that collapses in adulthood, usually caused by a failing posterior tibial tendon. Pain and swelling start on the inside of the ankle, and it progresses in stages, so catching it early matters.

Rigid Flatfoot

The foot stays flat and the arch will not return. The joints have stiffened, often from arthritis or a tarsal coalition. Rigid flatfoot is harder to treat without surgery because the support cannot simply be restored.

Flatfoot in Children

Common in young children, and usually outgrown. Treatment is usually only needed when there is pain, the foot is stiff, or one foot looks very different from the other.

Flexible or Rigid Flatfoot? How to Tell the Difference

This is the single most important question in a flatfoot exam, because it changes the whole treatment plan.

Flexible Flatfoot Rigid Flatfoot
Does the arch come back? Yes, when you sit or rise on your toes No, the foot stays flat
Usual cause Loose, stretched, or failing tendons and ligaments Stiff or fused joints, arthritis, tarsal coalition
Treatment usually means Orthotics, bracing, tendon-focused care Realigning or fusing bone to correct position
Non-surgical options More Fewer (support eases comfort, not position)

A simple in-office test, where we watch your foot as you rise onto your toes, tells us a lot. Weight-bearing X-rays confirm it. If you are not sure which type you have, that is exactly what a consultation answers.

You’ve Probably Already Tried…

Most patients who come in for flatfoot have already worked through some version of this list:

  • Arch-support insoles from the pharmacy
  • More supportive or motion-control shoes
  • Anti-inflammatory medications like ibuprofen or naproxen
  • Ice after activity
  • Stretching the calf and arch
  • Cutting back on standing, walking, or running
  • Weight loss to take load off the arch
  • A wrap or brace for the ankle

These help, and they are worth trying. Many people keep a flexible flatfoot comfortable for years with the right support. But store-bought insoles and shoe changes do not stop a tendon that is actively failing, and they cannot rebuild an arch that has already collapsed. They manage the symptoms while the deformity may keep progressing underneath.

Supportive shoes, arch support insoles, and an ankle brace used in non-surgical flatfoot treatment
Supportive shoes, arch supports, and braces: the kind of things most patients have already tried.

When to See a Foot and Ankle Specialist

Not every flat foot needs treatment. But here is when it is time to make the appointment:

  • Pain or swelling on the inside of your ankle that has lasted weeks and is not improving
  • Your arch looks lower than it used to, or one foot looks flatter than the other
  • It is getting harder to rise up onto your toes
  • Pain has started on the outside of the ankle, where the bones are now bumping together
  • Walking, standing, or stairs tire your feet far faster than they used to
  • Arch supports and supportive shoes are no longer enough

Early care changes the outcome

If any of those describe you, it is time, especially with the inner-ankle pain of adult-acquired flatfoot. This is one of the few foot problems where treating it early can change how far it progresses.

Ready to get back on your feet?

Most new patients are seen within the same week. Schedule your flatfoot evaluation with one of our five board-certified foot and ankle surgeons.

Treatment Options for Flatfoot

We start with the least invasive options that fit your case and step up only if those stop working. Surgery is the last step, not the first.

Most patients improve with these:

  • Custom orthotics built to support your specific arch and control the inward roll
  • Supportive or motion-control shoes that work with the orthotic
  • Bracing or an ankle-foot brace for a failing tendon or a more advanced collapse
  • Physical therapy to strengthen the posterior tibial tendon and stretch a tight calf
  • Anti-inflammatory medications, oral or topical, to calm pain and swelling
  • A walking boot for a short period to rest an inflamed tendon during a flare
  • Weight management to reduce the load the arch has to carry

For many people with flexible flatfoot, the right orthotic and a stronger tendon are enough to stay active and comfortable long term.

When non-surgical care has been tried and flatfoot is still causing pain or getting worse, surgery becomes the next step. The right procedure depends on the cause, whether the foot is flexible or rigid, and how far it has gone. Most reconstructions combine more than one of these:

Tendon repair or transfer. A damaged posterior tibial tendon is repaired, or a nearby tendon is rerouted to hold up the arch. Used for flexible adult-acquired flatfoot before the joints stiffen.

Bone realignment (osteotomy). The heel bone or other bones are cut and shifted to rebuild the arch and bring the foot back under the leg, taking pressure off the failing tendon.

Arch support implant. For some flexible flatfeet, a small implant placed in the foot helps hold the arch in a better position. Often combined with tendon work.

Joint fusion (arthrodesis). For rigid or arthritic flatfoot, the stiff, worn joints are fused in a corrected position. The foot no longer flattens and the arthritis pain ends, with the tradeoff that those joints no longer move.

Your surgeon will walk you through which combination fits your foot at the consultation.

What to Expect After Surgery

Flatfoot reconstruction is a bigger recovery than many foot surgeries because it often involves both bone and tendon. The exact timeline depends on what was done.

1

After Tendon Repair or Transfer

Usually an outpatient procedure. You spend several weeks in a cast or boot keeping weight off the foot, then gradually return to walking in the boot. Most patients are back in supportive shoes by about 3 months and back to full activity over 6 to 9 months as the tendon strengthens.

2

After Bone Realignment (Osteotomy)

The cut bone needs time to heal, so you stay off the foot in a cast or boot for roughly 6 to 8 weeks. Walking returns gradually after that, with most patients in normal shoes by 3 to 4 months and full recovery over 6 to 12 months.

3

After Joint Fusion

This is the longest recovery of the flatfoot procedures. Expect 6 to 8 weeks off the foot while the fusion sets, then a gradual return to walking. Comfortable walking usually comes by 4 to 6 months. The fused joints will not move, but the pain and the collapse are corrected.

Your surgeon will give you a specific timeline at the consultation, based on the procedure and your health. Flatfoot related to foot and ankle arthritis may be managed alongside that condition.

Why Patients Across Southwest Michigan Choose Kalamazoo Foot Surgery

Flatfoot is one of those conditions where having options matters. A failing arch can be managed with a custom orthotic, a brace, tendon-focused therapy, a single procedure, or a full reconstruction, and the right answer depends entirely on your foot. Kalamazoo Foot Surgery has five foot and ankle surgeons, each a Fellow of the American College of Foot and Ankle Surgeons (FACFAS), so your plan is matched to your condition and your goals rather than to whatever one doctor happens to do.

Serving Kalamazoo since 1978, with surgical privileges at Bronson, Ascension Borgess, and Woodbridge Hills. Patients drive in from across Southwest Michigan, including Portage, Battle Creek, Mattawan, Texas Township, Plainwell, Richland, Galesburg, and Paw Paw.

Dr. Rick Tiller, DPM, FACFAS, foot and ankle surgeon at Kalamazoo Foot Surgery

Dr. Rick Tiller
DPM, FACFAS
Foot & ankle surgery since 1991

Dr. Andrew Robitaille, DPM, FACFAS, foot and ankle surgeon at Kalamazoo Foot Surgery

Dr. Andrew Robitaille
DPM, FACFAS
Forefoot & reconstructive rearfoot surgery

Dr. Douglas Brewer, DPM, FACFAS, foot and ankle surgeon at Kalamazoo Foot Surgery

Dr. Douglas Brewer
DPM, FACFAS
26+ years of experience

Dr. Elizabeth Horton, DPM, FACFAS, foot and ankle surgeon at Kalamazoo Foot Surgery

Dr. Elizabeth Horton
DPM, FACFAS
Reconstructive surgery, trauma & sports

Dr. Jessica Patterson, DPM, FACFAS, foot and ankle surgeon at Kalamazoo Foot Surgery

Dr. Jessica Patterson
DPM, FACFAS
Wound care

What Our Patients Say

Frequently Asked Questions

What is flatfoot?
Flatfoot, also called fallen arches or pes planus, is when the arch on the inside of the foot is low or absent, so most of the sole touches the ground when you stand. Some people are born with flat feet and never have symptoms. Others develop a flat arch over time when the tendons and ligaments that support the arch stretch or weaken, which is more likely to cause pain.
Can flat feet be fixed without surgery?
In many cases, yes. Flexible flatfoot often responds well to custom orthotics, supportive shoes, bracing, and physical therapy to strengthen the supporting tendon. These can relieve pain and slow the progression of a falling arch. Surgery is considered when non-surgical care has not worked or when the arch is collapsing and getting worse.
Are flat feet a problem if they do not hurt?
Often not. Many people have flat feet their whole lives with no pain and need no treatment. The flat feet worth watching are the ones that hurt, that are getting flatter over time, or that started collapsing in adulthood, since those can point to a tendon problem that progresses if it is ignored.
What is the difference between flexible and rigid flatfoot?
In flexible flatfoot, the arch reappears when you sit or rise onto your toes, so the foot can still move into a better position. In rigid flatfoot, the foot stays flat no matter what because the joints have stiffened, often from arthritis or a tarsal coalition. Flexible flatfoot has more non-surgical options. Rigid flatfoot usually needs realignment or fusion to correct the position.
What is adult-acquired flatfoot?
Adult-acquired flatfoot is when an arch that used to be normal slowly collapses in adulthood, most often because the posterior tibial tendon on the inside of the ankle is failing. It usually starts with pain and swelling on the inside of the ankle and progresses in stages, so it is one of the more important flat-foot problems to catch early.
Will orthotics cure my flat feet?
Orthotics do not change the shape of the bones, but they do support the arch, control the inward roll, and relieve pain, and they can slow a worsening flatfoot. For flexible flatfoot, a good custom orthotic is often enough to keep you active and comfortable long term. They work best when matched to your specific foot rather than bought off a shelf.
Do children with flat feet need treatment?
Usually not. Almost all young children have flat feet and most develop an arch as they grow. Treatment is considered when a child has foot pain, when the foot is stiff rather than flexible, or when one foot looks very different from the other. We are happy to evaluate a child’s flat feet and tell you whether anything needs to be done.
How long is recovery from flatfoot surgery?
It depends on the procedure. Tendon work alone is the fastest. Bone realignment requires staying off the foot for about 6 to 8 weeks while the bone heals, with normal shoes by 3 to 4 months. Fusion takes the longest, with comfortable walking usually by 4 to 6 months. Most flatfoot reconstructions reach full recovery somewhere between 6 and 12 months.
Is flatfoot surgery painful?
There is discomfort after surgery, as with any bone or tendon procedure, but it is managed with medication and usually settles over the first couple of weeks. Most of the recovery is not about pain, it is about protecting the repair while bone and tendon heal, which is why the boot and cast time matters.
Will my flatfoot get worse over time?
A painless, flexible flat foot often stays the same for life. Adult-acquired flatfoot, the kind driven by a failing tendon, tends to get worse if it is not supported or treated, which is why inner-ankle pain and a dropping arch are worth getting checked early.
Does insurance cover flatfoot treatment and surgery?
Most insurance plans cover flatfoot care, including custom orthotics and surgery, when there is documented pain or loss of function and when conservative care has been tried. Coverage for specific items and procedures varies by plan. Our team will verify your coverage before scheduling.
Should I see a podiatrist or an orthopedic surgeon for flat feet?
Both can treat flatfoot. Podiatrists focus their entire training on the foot and ankle. An orthopedic surgeon treats the whole musculoskeletal system, with some doing fellowship training in the foot and ankle. Either can perform flatfoot surgery. The five surgeons at Kalamazoo Foot Surgery are board-certified podiatric foot and ankle surgeons (FACFAS), podiatry’s highest credential in this area.
How quickly can I be seen?
Most new patients can be scheduled within the same week. If you have sudden swelling on the inside of the ankle or a rapid change in the shape of your foot, call the office and we will do our best to fit you in as soon as possible.

Schedule Your Flatfoot Consultation

How you move forward depends on where you are.

Ready to schedule

Request an appointment online or call. Flatfoot consultations include weight-bearing X-rays, a full exam, and a clear treatment plan you can take home.

Have questions first

Call the office and our team will answer them, or schedule a short evaluation visit before committing to a full consultation.

Not sure it’s your arch

Schedule a regular evaluation. We will figure out what is actually causing your foot pain and discuss your options without pushing you toward surgery.