Splayfoot, flatfoot and fallen arches - It doesn't always have to be an operation

"Actually, 'the' perfect foot only exists in the textbook," knows Tonio Gottlieb, MD. "I prefer to speak of an average foot," explains the specialist surgeon and certified foot surgeon from Berlin-Zehlendorf.

"It has a longitudinal arch with a 'normal' height - that is, not too high and not too low. The heel is not placed too far out or in and the position of the foot is also according to the norm in all other planes." But in many people, the longitudinal arch of the foot lowers over time - a flat foot develops. Usually the foot bends to the side at the same time (buckling or bending flat foot). The flat foot often turns into a flat foot - the arch of the foot flattens. "It is similar to a crooked nose - not nice, but if I can get good air through it, no problem," explains Dr. Gottlieb. Only when pain occurs - for example on the inside of the ankle, which can also swell and become inflamed, or when the ball of the big toe hurts - does the foot expert advise seeing a specialist. "Whenever possible, I try to reduce the load conservatively with orthopaedic insoles by distributing the pressure better," describes Dr Gottlieb. "On the other hand, I can increase the load-bearing capacity - through physiotherapy or, as a last resort, through minimally invasive surgery if tendons or joints are already impaired." The goal is then to eliminate the deformity before the joints become too damaged. Depending on the cause, the flatfoot is corrected at the ligaments, tendons or joint capsule and, if necessary, also at the bone level (osteotomies or stiffening of hindfoot joints). "To grasp a problem in detail, you need a lot of time - assembly line work would be out of place," says Dr Gottlieb. After all, in addition to the statics of the foot, those of the entire body must always be taken into account. "Only in this way can you also treat in a sustainable and cause-oriented way."

Author: Peter Claußen

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