Flat Feet

Flat Feet
15-20 miles from East Indianapolis in Greenfield, Indiana

Flat feet (Pes planus) are very common. Flat feet can be very symptomatic, and cause severe deformity and arthritis, and other times never really necessitate formal treatment. Within the flat foot umbrella exists posterior tibial tendon dysfunction, or “fallen arches”. Both kids and adults can suffer from painful flat feet. In kids it is important to rule out a “tarsal coalition” – this is an abnormal connection of 2 bones in the hindfoot that occurred early in skeletal development.

Why Choose Hancock Orthopedics – Central Indiana & Greenfield Foot and Ankle Surgeon Doctor William J. E. Adams?
Fellowship Trained Foot & Ankle Surgeon

Doctor Adams is a Fellowship Trained Foot and Ankle Surgeon. He completed his Fellowship at American Health Network in Indianapolis. This is one of the most respected and longest running Fellowships in the country.

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If you are searching for a Foot and Ankle Surgeon who can provide you with pain relief associated with your flatfoot deformity, Central Indiana Foot and Ankle Surgeon Dr. Wil Adams will be happy to consult with you.

If you have questions or concerns, please feel free to call Dr. Adams at (317) 477-6683, or schedule a consultation online.

Learn more about Dr. Adams

Dr. Adams is a born and raised Hoosier. He attended Indiana University-Bloomington where he met his wife Allison. He got degrees in Nutrition Science, Biology and Chemistry. Dr. Adams then got his doctorate from Kent State College of Podiatric Medicine where he was a Dean’s List student. He then came back to Indianapolis to do his residency surgical training and was Chief resident. He stayed in Indianapolis and completed a specialty Fellowship focusing on Adult and Pediatric Reconstruction. During his Fellowship Dr. Adams helped launch the first foot and ankle dedicated surgical practice at Hancock Orthopedics, and has been employed there since.

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Dr. Adams enjoys teaching as he helps educate and train the surgical residents at Community Health Network, and the Fellows at American Health Network. He actively participates in research and editing for national peer reviewed journals.

He is also a consultant for orthopedic device companies where he is afforded the opportunity to help train and design with other surgeons across the country.

Dr. Adams has special interests in the following areas:

Arthroscopic joint surgery
Minimally invasive calcaneal fracture repair
Flat foot reconstruction, adult and pediatric
Vitamin D and its correlation with bone healing
Cartilage restoration for the ankle joint
Regenerative medicine
5th Metatarsal fractures
Non-union revision surgery

Dr. Adams is a father of two and resides with his family in Fishers. He enjoys the short commute to Hancock Health in Greenfield.

William J.E. Adams, DPM CV (pdf)

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Posterior Tibial Tendon Dysfunction (Adult Acquired Flatfoot Deformity, or “Fallen arches”)

Which comes first – the chicken or the egg? Posterior tibial tendon dysfunction kind of embodies this phrase. Does the PT tendon start to weaken allowing a collapsed arch? Or does a flat foot predispose people to PT tendon dysfunction? I personally feel that it is the latter. People, the vast majority of the time are born with the genetic blueprints to develop flat feet during skeletal maturation. Over time this faulty architecture takes it toll on the supporting soft tissues such as the spring ligament and the PT tendon. If proper support and treatment is not sought out the end result is painful Posterior Tibial Tendon Dysfunction (PTTD). There are stages of degeneration noted with PTTD. In early stages treatment options are more vast and successful. In the late stages of PTTD there are far fewer options available, and either robust bracing, or surgical correction is necessary to prevent total arch collapse and painful arthritis within the ankle joint.

Does arch collapse worsen over time?
Yes – PTTD is a degenerative condition. It cannot be reversed. With excellent care it can be very well managed, and even “corrected”.
Do arch supports/inserts help prevent PTTD?
Yes – arch supports can help control excessive motion (pronation), and provide support to the arch, therefore decreasing tension on the soft tissues/ligament. When left untreated patients with “fallen arches/PTTD” develop Spring ligament tears. The spring ligament is a very thick band of connective tissue underneath the talus bone that supports the arch, and acts as a buttress during weight bearing activities. When the spring ligament tears and becomes insufficient, arch collapse has taken place.
Does my body weight make PTTD worse?
It does not help. There are people with PTTD that are ideal body weight yet still struggle with flat foot pain and degeneration. However, your feet are your foundation and adding extra weight along the ligaments and tendons that support your arch only exacerbates the condition.
Is there a particular shoe that is best suited to prevent, or help minimize PTTD?
No – shoes are kind of like gloves, and every person seems to do best in what fits their feet best. However, generally speaking people with flatfeet (pes planus) need shoes where the instep/arch of the shoe is built up and has a synthetic “bridge” present. Shoe companies often refer to these shoe models as motion control, stability shoes, and similar synonyms. The shoe industry likes to use the term “over-pronation” to describe shoes made for people with flat feet.  
What other options are available for my painful flat feet since inserts failed to help me?
Both prescription and non-prescription ankle braces are great options for patients with painful arch collapse. These braces can be custom made from a cast of your foot, and they can also be “off the shelf/non-custom”. Most insurance companies do pay for bracing.
If braces fail to relieve my arch collapse is surgery an option?
Surgery is often very effective to fix a painful flatfoot. There are multiple ways to perform the surgery. Procedure selection is based upon the patients wishes, clinical needs, and based on x-rays.
How long does it take to recover from flatfoot surgery?
It depends on the procedures you and your surgeon choose. Generally speaking the non weight bearing period after surgery lasts 6-8 weeks – contingent upon bone healing. Many patients will be able to bear weight at week 6 in a walking boot. We hope to get patients back into a sneaker at 10 weeks, and start physical therapy. (Please realize all patients heal at different speeds, and these timeframes can vary substantially)

Pediatric Flatfeet (Juvenile Pes Planus)

Flat feet can bother both children and adults alike. The severity of the condition often dictates when the condition manifests. In instances where a flat foot is painful during childhood it is because the condition is more severe.

The condition is best diagnosed through a thorough physical exam, and x-rays. Diagnosing the deformity is actually more accurate with a xray, rather than an MRI as x-rays are taken while the patient is bearing weight – which provides a more accurate depiction of the bony architecture of the foot. While this is true – sometimes a MRI is still ordered to rule out a tarsal coalition.

Our first treatment option for symptomatic flat feet (pes planus) in children is always to utilize orthotics (shoe insert). This can help support the arch and take pressure of ligaments and tendons that are responsible for supporting the foot. This insert does not necessarily need to be an expensive custom device.

Children often complain of pain first by suggesting their “feet hurt”, or they are “tired of walking”. Occasionally, this is simply due to a long day of activities and can be associated with growing pains. When the complaint becomes recurrent this is when we recommend evaluation by a specialist.

When conservative care fails to allow resolution of symptoms to an acceptable level surgical intervention is appropriate.

The surgical options for pediatric flat feet are similar and also dissimilar to the procedures utilized to correct adult flat feet. Both the Evans and Cotton osteotomies are procedures routinely utilized due to their utility, and predictability. In more mild cases soft tissue procedures, and an arthroeresis procedure may be appropriate. These decisions are carefully made with the patient, surgeon and parent.

WE ARE LOCATED LESS THAN 30 MINUTES FROM EAST INDIANAPOLIS!
Foot & Ankle Surgeon near Indianapolis

Are you an Indianapolis resident seeking a foot & ankle surgeon?

Dr. Wil Adams is close and worth the short drive.

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Accessory Navicular

Accessory Navicular bones can come in three variations. The most basic, and common type of Accessory navicular is where a small piece of bone that lies adjacent to the navicular bone is embedded within the Posterior tibialis muscle tendon at it’s attachment site. Due to overuse, trauma, flat feet, and other causes this bone and the tendon interface can become inflamed. When the process initiates, and fails to get better is the definition of “Accessory Navicular Syndrome”.

Can trauma elicit accessory navicular syndrome?
Yes – it’s possible to live many years with an accessory navicular bone never being aware you have one. Then one day a traumatic event such as an ankle sprain, or an awkward step can cause the PT tendon to pull on the accessory bone causing the interface between the accessory bone and the tendon to become very aggravated. On occasion they do need to be surgically excised.
Does accessory navicular syndrome mean I have flatfeet?
No. There are instances where people that have accessory navicular syndrome also have flatfeet. But there are also many individuals that have accessory naviculars that have fairly neutral or rectus foot types.
Do I need to have my accessory navicular bone surgically excised if it has been painful before?
No – not necessarily. The only time surgery is necessary is when a patient has failed multiple attempts and different types of conservative care to try and resolve the issue.

REQUEST A CONSULTATION WITH DR. ADAMS: 317-477-6683

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