Flat feet should never be ignored. They lead to all sorts of problems not only within your foot but up your body adversely affecting your knees, hips and back. Actually, your misaligned feet can even affect your health in general - the most recommended treatment for diabetes, high blood pressure and obesity is to go out and walk. But how can you walk if your feet hurt you as a result? This presentation discusses why your feet go flat and what can be done to fix them. Refuse to ignore one of the most commonly used parts of your body - your feet.

1. Their feet
are slowing
them
down?
Flexible Flat Feet In Children

2. Your feet can dramatically
affect your quality of life

3. Misaligned feet are NOT a good thing –
even if you don’t have low or flat arches.

4. Foot alignment is critical for
standing, walking and running.

5. WHAT ARE FLAT FEET?
• A common problem affecting
millions of children and adults.
• Typically, there is a lowering of
the arch.
• This condition is usually
ignored and patients are told
they will simply out-grow this
condition.
The reality is very different.
Normal
Not Normal

6. There are 2 medical conditions that can
lead to a misaligned or flat foot.
• Pes Planovalgus
– This is a complex situation where there are many
bones of the foot that are out of alignment.
• Talotarsal Joint Dislocation
– This is also a pathologic condition where the ankle
bone partially slips of it’s normal alignment on the
heel bone.

7. What’s the difference?
Can we all agree that these are flat feet?

8. What’s the difference?

9. This is an example of
Recurrent TaloTarsal Joint Dislocation
(RTTJD)
The only difference between these images is one
where the ankle bone is displaced on the heel bone
and the other is where the ankle is where it is
supposed to be.

10. This foot can be corrected
with a rather simple solution.

11. The other…not so simple.

12. What do misaligned feet look like?
There appears to be 2
ankle bones on the inside
of the hindfoot.
The ankle bone turns in-ward
and the forefoot
turns out-ward.

13. Misaligned feet can also
cause your knees to turn in.
Knees rotated in . . . instead of correctly aligned.

14. Misaligned feet lead to a chain reaction
of damage throughout the body.

15. Aligned Feet = Aligned Body

16. Misaligned Feet = Misaligned Body!

17. Misaligned feet eventually lead
to other symptoms.
“The more active I am, the worse my pain;
the less active I am, the pain isn’t so bad.”

18. No Symptoms Yet?
• Imagine your foot
acting as the tire on
your car.
• You can place the tire
(or foot) on the ground
without balancing it.
• It functions great, for
awhile.
BUT…

19. Alignment Matters!
• Sooner or later it will wear
out.
• Not only is the single tire
(or foot) affected, but it can
adversely affect the other
tires – or the rest of our
body.
• The steering also becomes
misaligned – just like our
body.

20. The majority of people with misaligned feet
DON’T have pain in their feet.
Instead, the pain will show up elsewhere,
such as the knees, hips or back.
The symptom(s) of mis-aligned feet will show up at the
“weakest link in the chain.”

21. Signs That Can Indicate
Misaligned Feet in Children
• Child wants to be held/carried
longer/more often than
others, especially when
walking.
• Child is not interested in
sports or physical activities.
• Child is more clumsy or
uncoordinated than others.

22. Signs That Can Indicate
Misaligned Feet in Children
• Child runs significantly slower than
classmates.
• Child’s shoelaces repeatedly
come untied (due to
movement & rolling of feet.)
• Child leaves shoes untied and/or
doesn’t want to tie and re-tie shoes.

23. Signs That Can Indicate
Misaligned Feet in Children
• Child experiences significant growing
pains at bedtime, waking up shortly
after falling asleep with pain or feeling
pain as they fall asleep.
• Child is excessively overweight.
• Child has flat feet or “Too Many Toes
Syndrome.”

24. What’s the Fix?

25. Treatment Option - Observation
Watching and waiting just
leads to increased damage.
Instead of getting better, it
gets worse.
Here’s what 50 years of
observation would look like.

26. Benefit – Risk Analysis
Observation
• Benefits:
– Non-surgical option
– Relatively inexpensive
– Does not rely on patient
compliance
– No anesthesia/surgical
risks
• Risks:
– Progression of the disease
process
– Every step is inefficient
– Excessive abnormal strain on
supporting soft tissue
structures
– Mal-alignment to other
structures within the foot &
ankle and also up the
musculoskeletal chain
– Possibility of long-term
complications

27. Treatment Option - Orthoses/Shoes
• Arch supports can’t
stabilize the ankle bone!
• They give a false sense of
correction.
• The are NOT corrective,
just supportive.
• Compliance issues – patient
must wear them for them
to be effective.

28. Treatment Option - Orthoses/Shoes
• Benefits
– Non-surgical option
– Initially relatively
inexpensive (but need
frequent replacement)
– No potential
anesthesia/surgical
complications
• Risks
– Not proven to decrease
tissue strain
– Not proven to improve
radiographic measurements
– Can lead to other problems-increased
pain
– Patient compliance issues
– Need new devices made
regularly
– Have to be worn in shoes

29. Treatment Option –
Reconstructive Surgery
Is this really necessary?
There has to be a better option!

30. Benefit – Risk Analysis
Rearfoot Reconstructive Surgery
• Benefits:
– Radiographic correction
– Internal correction
– Does not rely on patient
compliance
– May be covered by
insurance companies.
• Risks:
– Major Surgery
– Surgical Risks
• Non-union
• Infection
• Need for revision
• Need to remove internal
hardware
– Anesthesia Risk (low)
– Expensive
– Long recovery

31. Treatment Option –
Extra-Osseous TaloTarsal Stabilization (EOTTS)
Internal Correction for RTTJD
• Minimally invasive, internal option
• Permanent yet reversible
• Used in both children & adults
• Time-tested & evidence-based

32. Extra-Osseous TaloTarsal Stabilization (EOTTS)
A titanium stent is
placed into a naturally
occurring opening
between the ankle and
heel bones.

33. HyProCure® EOTTS
• HyProCure® is an internal
bone stabilization device
• It prevents the abnormal
collapse of the sinus tarsi
• Made of medical grade
titanium
• Does not fragment or
wear out
• FDA cleared/CE marked
Before
After

34. HyProCure® EOTTS
BENEFITS
• Internal correction
• Effectively stabilizes the ankle
bones
• Not dependent on external
factors-shoes, braces, etc.
• Should be a “permanent”
solution, but can always be
resized or removed if needed.
• Proven to decrease strain on
supporting tissues
RISKS
• Stent displacement
• Period of abnormal walking,
pain, swelling
• Soft tissue adjustment
• Need for stent removal
• Other risks associated with
surgery.

35. HyProCure® - an Effective Solution for Children

36. Don’t Let Your Child’s Feet
Slow Him or Her Down!
For more information, please visit:
www.AlignMyFeet.com
or
www.HyProCure.com