Hyperpronation (flatfoot) is a very common condition of excessive motion of the rear foot that causes the appearance of a collapsed arch upon weight bearing. This motion leads to deformity of the foot and potentially knee, hip, and back problems. It occurs with every step a person takes and eventually leads to damage to the musculoskeletal system. This is why most people develop lower extremity symptoms by middle age, or even earlier depending on the degree of deformity. In other words, if your feet are out of alignment, sooner or later the effects will be felt.
You should not wait to have pain or deformities to treat hyperpronation. As with any other deformity, the sooner treatment is initiated the better the outcome. Oral medications do not address the underlying deformity, which is excessive motion of the ankle bone (talus) on the heel bone (calcaneus).
Historically, arch supports have been the gold standard in treating abnormal foot motion. This type of treatment has been very successful in preventing the abnormal motion, but does not address the underlying internal cause of the deformity to afford a permanent cure. The other disadvantage of arch supports is that they will limit the shoes you may wear (no sandals or high heels) and when you are not wearing the supports, you will not be getting any correction of the deformity or relief of symptoms (for example, when you are barefoot).
Subtalar arthroeresis is a very viable in-office treatment option for the permanent correction of hyperpronation for anyone over the age of three years.
The procedure involves placing a small medical grade titanium implant in the sinus tarsi, which is the opening between the talus and calcaneus. This acts as an internal orthotic to prevent the abnormal motion (collapse) between the two bones. The titanium is tolerated by the body without ill effects. It is specifically designed to fit securely into the sinus tarsi without any type of internal fixation (screws, pins, etc.). It does not deteriorate over time or set of a metal detector. It is stronger than bone.
The procedure takes approximately 10-15 minutes and is performed though a small ¾ inch incision on the outside of the foot in an office or outpatient ambulatory center. It may be performed under local anesthesia or local anesthesia with light IV sedation. Also, since no boney structures are being disturbed, the procedure is totally reversible.