Flatfoot

Progressive Collapsing Foot Deformity

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Most people with a flatfoot -- also known as a low arch -- have no symptoms and lead normal, active lives. When a flatfoot progresses, it can cause pain or limit your mobility. That’s when it’s time to see a foot and ankle specialist for a thorough evaluation. Left untreated, a flatfoot can lead to increased pain, loss of function, and arthritis. Duke foot and ankle specialists use the latest diagnostic tools, including standing CT, to assess your arches and the severity of your condition. We offer the full range of treatments, from physical therapy to flatfoot reconstruction, to ease your pain and restore your mobility.

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About Flatfoot

Flatfoot can happen when the arches in your feet fail to develop during childhood. This condition occurs for many reasons but is often inherited. Sometimes people with normal arches experience flatfoot later in life because of an injury or normal wear and tear. Being overweight and participating in high-impact activities like running can cause pain on the inside or outside of your foot and ankle. If you have low arches that are getting worse, have recently developed low arches, or have foot or ankle pain that limits your mobility, flatfoot treatment can prevent further damage. 

Our Locations

Duke Health offers locations throughout the Triangle. Find one near you.

Flatfoot Treatments

Having a flatfoot is normal, but having a flatfoot that is collapsing -- doctors call this progressive collapsing foot deformity -- is not. We offer a range of treatments for managing or correcting this condition.

Nonsurgical Treatments

If you are experiencing pain or limited mobility, your doctor may recommend one or more of the following nonsurgical treatments:

  • A change in footwear 
  • Over-the-counter or custom orthotics
  • Braces or a stabilizing boot 
  • Physical therapy to strengthen tendons in your foot and ankle 

Flatfoot Reconstruction Surgery

Surgery to correct progressive collapsing foot deformity -- called flatfoot reconstruction -- varies depending on the severity of your condition. When problems are caught early, your surgeon can repair tissues and realign the foot and ankle by making bone cuts to rebuild the arch and realign the foot under the ankle. If you have severe foot collapse, joints in your foot and ankle may need to be fused. Whenever possible, we use less invasive techniques to minimize your pain and speed your recovery. After flatfoot reconstruction, you will not be able to bear weight for about six weeks. You will wear a supportive boot for an additional six weeks before returning to soft shoes or sneakers.

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Tests for Flatfoot

Physical Exam
Doctors can usually diagnose progressive collapsing foot deformity by examining your feet and ankles as you sit, stand, and walk. 

Imaging Tests
X-rays, MRIs, and other imaging tests show your doctor if your low arches are causing alignment problems, arthritis, or tissue damage. They also help to determine if and when surgery is necessary. 

Standing CT
Duke is one of a few centers in North Carolina to offer standing CT scans. This advanced technology produces a detailed 3D image of your feet and ankles as they bear weight. It also uses less radiation than a traditional CT scan.

Best Orthopaedic Hospital in North Carolina

Where you receive your care matters. Duke University Hospital is proud of our team and the exceptional care they provide. They are why our orthopaedics program is nationally ranked, and the highest-ranked program in North Carolina, according to U.S. News & World Report for 2024–2025.

Why Choose Duke

Walk-In Orthopaedic Urgent Care
Our convenient orthopaedic urgent care clinic is open seven days a week. Get fast service with no long waits and no unnecessary exposure to illness. No appointment needed.

Extensive Experience
Duke foot-and-ankle specialists perform hundreds of surgical procedures each year. They are board-certified, and fellowship-trained in foot and ankle surgery.

Advanced Diagnostic Technology
We offer the most advanced technologies to accurately diagnose foot and ankle problems that affect your quality of life. We are one of a few centers in North Carolina to offer standing CT scans for foot, ankle, knee, and hip conditions.

This page was medically reviewed on 06/21/2023 by