Maggie McKay (Host): Most of us take our feet for granted until we realize how crucial they are to every step we take. So today, Dr. Zach Lind, Doctor of Podiatric Medicine, will discuss foot health. Welcome to Stoughton Health. I'm your host, Maggie McKay. Thank you so much for being here, Dr. Lind.

Zachary Lind, Doctor of Podiatric Medicine: Yeah. Thanks for having me on. Excited to be here.

Host: Me too. I can't wait to hear more about this because I think most people have experienced some kind of foot pain or injury in their life. So this should be a good one. So, what does it mean to have flat feet or high arches?

Zachary Lind, Doctor of Podiatric Medicine: Yeah. So a flat foot condition would be one where the inside of your foot is like it sounds, it collapses. So you don't have that nice arch support that a normal person's foot would have. On the flip side of that, you can have a high arch, which causes completely different issues in the foot. And that's where your arch is too high. And it causes more prominence, bony prominence type issues than a flat foot would, which is more sort of tendinous type issues.

Host: What are the symptoms of flat feet or high arches?

Zachary Lind, Doctor of Podiatric Medicine: They tend to be very different. Flat feet tends to be more, like I said, pain along the inside. It tends to be a tendon on the inside called the posterior tibialis tendon that gets inflamed. Both can have limitations or excess motion in joints, which can cause joint pain, really flat feet when you, and high arches, based on how the forces go through your foot when you're walking or running, can cause irritation in all those joints, as well as the ankle joint. And really end stage of both is a tilting of the ankle within the joint; that can cause significant pain and arthritis and limitations in activities.

Host: What are the symptoms?

Zachary Lind, Doctor of Podiatric Medicine: So, it tends to be pain first. High arches tend to be pain more on the heel or on kind of the outside of the foot, just based on how you're walking, you're putting more pressure on the outside of your foot. Flat feet tend to be more on the inside of the foot because of the foot sort of drags out to the side. Flat feet can also cause bunions.

Both of them can cause plantar fasciitis type symptoms. Both of them can cause hammer toes as well. So they're sort of contributory to multiple different issues in the foot. But they tend to just vary with high arch being more outside of the foot pain and low arches being more inside of the foot pain.

Host: Are you just born with those or is it possible to develop them over the years?

Zachary Lind, Doctor of Podiatric Medicine: You can absolutely be born with either one of them. A lot of the times you'll see flat feet with injuries or just ligamentous type issues. So people who develop, you know, Ehlers Danlos or something along those lines where they just have insufficient ligaments, that are just too, they're not structurally supportive.

High arches you can also see in neurologic type symptoms where people will lose muscle tone in different areas of the leg and you'll start developing it over time. But there definitely is a congenital flat foot and a congenital high arch foot type.

Host: And what are the treatment options and or rehabilitation for flat feet and high arches?

Zachary Lind, Doctor of Podiatric Medicine: For flat feet specifically, we tend to, if it's flexible, meaning that we can still get them back to a neutral position. They tend to do very well with over the counter orthotics. If they have a little bit more deformity, we might go something along the lines of a custom orthotic or a U-C-B-L more aggressive brace type setting.

If it's really longstanding and there's some arthritis setting in, we'll sometimes use an ankle foot orthosis or an AFO that also incorporates the ankle. It's a bit more sturdy and just kind of gives more support. Physical therapy, if it's early on, or if it's kids, you can train the muscles a little bit and kind of strengthen them to work on it.

Kids specifically, almost all kids walk flat feet early on and that sort of develops over time and as the bones sort of grow the way they should, they usually sort of work out of that flat foot stage around age five to six.

High arch, you can also get inserts that have more of a high arch position. Like I said, it tends to be more of a prominence pain than a ligamentous pain, so it's more cushioning in the high arch foot because the high arch foot tends to be more locked up. It's not as mobile. It's more rigid than the flat foot counterpart.

Host: And what does recovery look like after treatment?

Zachary Lind, Doctor of Podiatric Medicine: If you're talking surgery, it depends on the type of surgery and the extent of the surgery. These are fairly large reconstructive type surgeries. So there's multiple either fusions or bone cuts and osteotomies and moving things where they need to be. It includes tendonous, ligamentous work as well.

When you really take into consideration all of those things, you're looking somewhere around that eight week mark of without putting weight on the foot and then sort of slowly transitioning to weight bearing around that eight to 12 week kind of depending on how the patient's doing and then moving into physical therapy from there.

So if you're talking a major reconstructive flat foot or a cavus foot would be the high arch component of it; you're looking at probably six months of true rehab and getting back and feeling like you're starting to get back to what you were doing.

Host: Wow, that's a commitment. It's a serious surgery, it sounds like.

Zachary Lind, Doctor of Podiatric Medicine: Yeah, absolutely.

Host: Well, thank you so much for being here today and sharing this useful information with us.

Zachary Lind, Doctor of Podiatric Medicine: Yeah. Thanks for having me on.

Host: Again, that's Dr. Zach Lind, and if you'd like to learn more, please visit StoughtonHealth.com. And if you found this podcast helpful, please share it on your social channels and check out our entire podcast library for topics of interest to you.

I'm Maggie McKay. Thanks for listening to Stoughton Health Talk presented by Stoughton Health.