Dovolená 27.–31. 10. 2026: ordinace zavřena, objednávky online fungují.

Orthopedics · Foot and ankle

Flatfoot in adults

Does the inner side of your foot and ankle hurt, and is your arch slowly dropping? In the early stage, insoles, a brace and exercises relieve the pain for most people. If that is not enough, surgery corrects the position of the foot so that the pain eases and the deformity does not get worse. If everything is in order, the procedure can take place as soon as within a week of the consultation.

Book an orthopedic consultation How the procedure works
  • No referral from a general practitioner needed
  • Surgery by Prof. MUDr. Radek Hart

Foot tendon, ligament and bone reconstruction

1 weekthat soon the procedure can take place
treatment starts
without surgeryinsoles, brace and exercises; in the early stage usually enough
patience
3 monthsor longer; pain can last this long even with early treatment
until the procedure
1 weekfrom the consultation, if everything is in order
healing after surgery
6 monthsor longer, until the foot has healed and the pain eases significantly

When a procedure is considered

Pain on the inside of the foot and an arch that drops

A flat foot is common and usually causes no problems by itself. In adults, however, the arch can gradually drop, most often because of the tendon of the posterior tibial muscle. It runs behind the inner ankle bone into the foot and holds the arch up. When it becomes inflamed or partially tears, the arch collapses, the ligaments are overloaded and the deformity can slowly get worse.

  1. Pain on the inner side

    The arch or the inner side of the foot and ankle hurts where the tendon runs, and sometimes there is swelling. Pain can appear before the change in the shape of the foot is visible.

  2. Weakness when walking and standing

    Standing and walking for long is harder, and running is difficult. Pain is often worse in shoes without support, for example sandals. Push-off and standing on tiptoe get weaker.

  3. Later it hurts on the outside too

    As the arch drops, the heel can tilt outward and press on the outer ankle bone. Then the outer side of the ankle hurts as well. Without the support of tendons and ligaments the bones shift and arthritis can develop.

  4. Who is at higher risk

    Women and people over forty. Being overweight, diabetes and high blood pressure raise the risk, and heredity plays a big part too.

Diagram of the foot from the inner side with a healthy arch: the tendon of the posterior tibial muscle runs behind the inner ankle bone to the arch bones, and the arch is raised off the ground Healthy arch posteriortibialtendon tendon holdsarch bones arch is raised off the ground Diagram of an adult flatfoot from the inner side: the tendon of the posterior tibial muscle is swollen and weakened, the arch bones have dropped and the whole sole of the foot rests on the ground Flatfoot in adults swollen,weakened ortorn tendon arch boneshave dropped whole foot rests flat on the ground
  • tendon of the posterior tibial muscle
  • bones
  • outline of the foot
  • original height of the arch
Simplified diagram of the foot from the inner side, not an actual image.

Treatment

First without surgery, if that is enough

Most patients in the early stage can be treated without surgery. Insoles, a brace and medication will not change the shape of the foot, but they often relieve pain and take strain off the tendon. Improvement takes patience. Which approach is right for you is decided by the doctor at the consultation.

Step 1

Relief and adjusted activity

At home, without a procedure.

  • Cut back on activities that hurt; cycling, an elliptical trainer or swimming instead of running
  • Comfortable, wide shoes with a low heel, no sandals without support
  • Cooling wrapped in a towel, 20 minutes 3 to 4 times a day; losing weight takes strain off the arch
  • Pain and anti-inflammatory medication after consulting a doctor; it does not address the cause

Step 2

Insoles, brace and exercises

When adjusting the load is not enough.

  • Insoles in your shoes support the arch; with a more marked change of shape they are made to measure
  • A lace-up ankle brace takes strain off the tendon; for a stiff foot, a firmer custom-made brace
  • Physiotherapy: strengthening the tendon and stretching the calf and Achilles tendon
  • If nothing helps, a cast or immobilizing boot for 6 to 8 weeks so the tendon can rest

Step 3

Surgery

When pain persists after months of treatment.

  • Pain does not improve even after several months of suitable treatment
  • The arch keeps dropping and the foot gets weaker or stiffer
  • The outer side of the ankle already hurts too, or arthritis is showing up in the joints

Is your flatfoot new, only on one side, painful, stiff or weak? Come for an examination, even if you do not need surgery yet. Book a consultation

How the procedure works

From booking to getting home

The surgery is planned precisely for your foot: according to how large the deformity is, whether the foot is still flexible and whether arthritis has already developed. Several steps are often combined. The damaged tendon can be replaced by another tendon from the foot (tendon transfer), loosened ligaments are tightened and the position of the bones is corrected. In a stiff foot with arthritis, the joints are fused so that the bones heal together in the correct position (arthrodesis). The aim is to ease the pain and stop further worsening.

  1. Booking

    Online or by phone. A referral from a general practitioner is not required.

    online or phone

  2. Consultation and examination

    Prof. Hart examines the foot standing and from behind, tests standing on tiptoe on one leg and the flexibility of the foot. The position of the bones is shown by an X-ray of the foot taken standing, the condition of the tendon by ultrasound or magnetic resonance imaging.

    diagnosis and treatment plan

  3. Procedure

    Under anesthesia. The extent and length of the surgery depend on how many correction steps your foot needs.

    as soon as within a week

  4. Home

    You go home as soon as everything is in order. Do not put weight on the operated foot until the doctor allows it; you will receive the exact plan before the procedure.

    check-ups and physiotherapy

Recovery and physiotherapy

The foot heals over months

The larger the deformity, the longer the recovery and the smaller the chance of returning to sport. We will help you with a plan for convalescence and rehabilitation; if needed, we follow on with physiotherapy right at the clinic.

Room in the short-stay ward of HR Clinic

  1. Weight bearing only on the doctor's instruction

    The most important thing after surgery is not to put weight on the foot before the doctor allows it. Bones and tendons need time to heal in the correct position.

  2. 6 months or longer

    That is how long it takes in most patients until the foot has healed and the pain is much less.

  3. What helps the result

    Sturdy shoes with support, lower weight and avoiding impact sports. Smoking and untreated diabetes increase the risk of complications.

  4. Realistic expectations

    Most patients have a good result from surgery. But the pain may not disappear completely, and the foot may not look the way it used to. The main goal is that the pain and deformity do not get worse.

Prof. MUDr. Radek Hart, Ph.D., FRCS, MHA

Who operates

Prof. MUDr. Radek Hart, Ph.D., FRCS, MHA

Orthopedic and trauma surgeon of the musculoskeletal system, head physician of HR Clinic. At a clinic in Vienna he is head of the foot outpatient clinic. He sees patients in Znojmo and in Vienna; after a consultation in Vienna the procedure can be performed in Znojmo.

More about Prof. Hart Specialist website ortho-hart.at

Price We will tell you the price of the procedure at the consultation, depending on the findings and the extent of the procedure.

Common questions

What patients ask most often

Related procedures

Unstable ankle after a sprain Ankle arthritis Bunion and forefoot Achilles tendon treatment

Related articles

How HR Clinic works
Does a flatfoot need treatment?

Not always. A flat foot is common, and if it does not hurt or limit you, it needs no treatment. It is worth having it examined if the foot hurts, gets stiff, weak or numb, if you injure yourself often, if your walking or balance is getting worse, or if the flat foot has appeared recently or on one side only.

Do insoles help?

Insoles are the most common non-surgical treatment of a flat foot. They support the arch and relieve pain, but they do not change the shape of the foot. They help most in the early stage, while the foot is still flexible. With a more marked change of shape they are made to measure, and for a stiff foot a firmer brace may help.

Does an injection help?

A corticosteroid is usually not injected into the tendon of the posterior tibial muscle because it increases the risk of the tendon rupturing. Taking load off the foot, cooling and medication tend to help more against pain and swelling.

When will I be able to walk after surgery?

It depends on everything that is corrected during surgery. Do not put weight on the foot until the doctor allows it; you will receive the exact weight-bearing plan before the procedure.

How long will I stay at the clinic?

The stay at the clinic lasts 24 hours at most. If you needed a longer hospital stay after a larger procedure, we will arrange follow-up rehabilitation care at the Dačice Rehabilitation Institute, covered by public health insurance.

What are the risks of the surgery?

Most often, that the pain does not disappear completely. Sometimes the bones do not heal together and another operation is needed, and a wound infection can occur. Smokers and people with diabetes have a higher risk of complications. What you can expect for your own foot, we discuss before the procedure.

Do I need a referral from a general practitioner?

No. It is enough to book online or by phone.

How soon can I have the procedure?

If everything is in order, the procedure can take place as soon as within a week of the consultation. We arrange the date according to the result of the examination.

Booking

Book an orthopedic consultation

Online or by phone, at the clinic in Znojmo. A referral from a general practitioner is not required.

Book a consultation
Book a consultation