Realignment procedures of the foot

Pain or instability in the back or middle of your foot can make standing, walking or staying active uncomfortable. Novant Health foot and ankle specialists offer hindfoot and midfoot realignment to help restore alignment and stability so you can move with less pain. We take time to understand how your foot affects your daily life and build a personalized plan to support long-term mobility.

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What is hindfoot and midfoot realignment?

Hindfoot and midfoot realignment is a treatment approach used to correct alignment issues in the back or middle of the foot. These issues can cause pain, instability and difficulty walking or standing for long periods.

This treatment may involve nonsurgical care or foot alignment surgery, depending on the cause and severity of your condition. Your foot and ankle specialists will evaluate your symptoms, walking pattern and imaging results to recommend the option best suited to relieve pain and improve function.

Common reasons for hindfoot and midfoot realignment

Realignment surgery may be an option if nonsurgical care doesn't provide enough relief. Your foot and ankle specialists may recommend it for conditions such as:

Flatfoot
Arthritis in the hindfoot or midfoot
Old fractures that healed out of alignment
Tendon imbalances or other alignment issues
Pain or instability that affects daily activities

Before recommending surgery, your care team reviews your symptoms, examines your foot, evaluates imaging and observes how you walk. The goal is to restore alignment, reduce stress on joints and tendons and improve function.

Treatment options (surgical and nonsurgical)

Nonsurgical

Whenever possible, we start with nonsurgical care to relieve pain and support your foot. Your care plan may include:

Custom orthotics to support and reduce pressure on the foot
Bracing for added stability while walking and standing
Physical therapy exercises to build strength, flexibility and balance
Medication or injections to ease pain and inflammation
Footwear and activity guidance to protect the foot and maintain mobility

Surgical

If surgery is needed, our orthopedic foot and ankle surgeons use advanced techniques to restore balance and alignment while preserving motion whenever possible. Surgical options may include:

Bone repositioning (osteotomy) to correct alignment
Tendon balancing or transfers to restore proper support
Joint fusion to stabilize painful or damaged joints when necessary
Minimally invasive approaches when appropriate
Fracture fixation with plates or screws to support proper healing

Your surgeon will guide you toward the treatment approach that fits your needs and goals.

Recovery and rehabilitation

Our Enhanced Recovery After Surgery (ERAS) approach helps reduce pain, support healing and guide your return to activity safely:

First weeks: Protective boot or cast with limited weightbearing
Weeks 6 to 12: Gradual walking paired with physical therapy
Following months: Continued strengthening and return to everyday activities

Your care team follows your progress closely and adjusts your plan to meet your goals. After recovery, we provide guidance on supportive footwear, orthotics and exercises to help protect alignment and maintain comfort.

Risks and considerations

As with any surgery, hindfoot and midfoot realignment carries some risks, which may include infection, delayed healing or ongoing discomfort in the treated area. Your care team will discuss these considerations with you in detail and answer any questions before moving forward with treatment, so you feel confident and informed every step of the way.

Conditions we treat

Our expert team delivers expert care for a wide range of foot and ankle conditions.

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Why treatment is important

Foot alignment issues can make everyday movement difficult and limit your ability to stay active and comfortable. Addressing pain and instability early can help protect your joints and support long-term mobility. Your care team is here to guide you toward a treatment plan that fits your life and goals.