Feet usually have an arch on the inside portion of the foot. A flat foot is a foot that has lost or never developed this arch. It is often associated with the lower part of the legs being angled outwards. Most flat feet are flexible. This type rarely causes problems and usually do not require treatment. Rigid flat feet can cause problems and are best treated.
There are a number of different causes that can lead to flat feet or fallen arches. These include, birth defects, while technically not a defect as such, flat feet can be a normal finding in patients from birth. However, a condition called tarsal coalition may occur where some of the bones in the foot are fused together resulting in a flatfoot. Inflammation or damage of the posterior tibial tendon. This tendon forms the end of a muscle that connects the lower leg to the foot, winding around the ankle and attaching to the inner aspect where the arch is normally present. The main role of the posterior tibial tendon is to invert the foot and maintain the arch height throughout the gait cycle. Torn muscles of the leg and foot can cause flat feet. Problems with the nerve supply to the muscles can result in reduction in tone and fallen arches. Fracture dislocation of the bones in the foot. Severe arthritis. While these are the common causes that can result in fallen arches and flat feet, it is important to recognise that there are certain risk factors that can also lead to this condition. These include advancing age, diabetes mellitus, high blood pressure, obesity and pregnancy.
Having flat feet can be painless and is actually normal in some people. But others with flat feet experience pain in the heel or arch area, difficulty standing on tiptoe, or have swelling along the inside of the ankle. They may also experience pain after standing for long periods of time or playing sports. Some back problems can also be attributed to flat feet.
Diagnosis of flat feet or fallen arches can be made by your health practitioner and is based on the following. Clinical assessment involving visual gait assessment, as well as biomechanical assessment. A detailed family and medical history. A pain history assessment determining the location of painful symptoms. Physical palpation of the feet and painful areas. Imaging such as MRI or x-ray can be used by your practitioner to assist in the diagnosis.
Non Surgical Treatment
If you have flat feet (pes planus) it does not mean you will have problems or pain. Flat feet are a common condition. Flat feet are defined as an abnormal lowering of the medial longitudinal arch. There is often a hereditary component to the development of flat feet. Flat feet are more common in certain ethnic groups. Flat feet usually occurs equally in both feet and become apparent at an early age. Flat feet can initially be asymptomatic, but can become progressively symptomatic with age. Some flat feet never become bothersome. The medial arch is unstable in flexible flatfoot. The foot can bend as the heel lifts of the ground. This creates stress on the surrounding soft-tissues and joints creating tired, sore arches. The instability of the foot can create abnormal stress that flows up the leg which results in pain in the legs, knees, hips and lower back. Patients with flat feet often present to the chiropodist/podiatrist with problems that are indirectly caused by their foot structure.
Since there are many different causes of flatfoot, the types of flatfoot reconstruction surgery are best categorized by the conditions. Posterior tibial tendon dysfunction. In this condition, the tendon connecting the calf muscle to the inner foot is torn or inflamed. Once the tendon is damaged it no longer can serve its main function of supporting the arch of the foot. Flatfoot is the main result of this type of condition and can be treated by the following flatfoot reconstruction surgeries. Lengthening of the Achilles tendon. Otherwise known as gastrocnemius recession, this procedure is used to lengthen the calf muscles in the leg. This surgery treats flatfoot and prevents it from returning in the future. This procedure is often combined with other surgeries to correct posterior tibial tendon dysfunction. Cleaning the tendon. Also known as tenosynovectomy, this procedure is used in the earlier and less severe stages of posterior tibial tendon dysfunction. It is performed before the arch collapses and while the tendon is only mildly affected. The inflamed tissue is cleaned away and removed from the remaining healthy tendon. Tendon transfer. This procedure is done to correct flatfoot and reform the lost arch in the foot. During the procedure, the diseased tendon is removed and replaced by tendon from another area of the foot. If the tendon is only partially damaged, the inflamed part is cleaned and removed then attached to a new tendon. Cutting and shifting bones. Also called an osteotomy, this procedure consists of cutting and reconstructing bones in the foot to reconstruct the arch. The heel bone and the midfoot are most likely reshaped to achieve this desired result. A bone graft may be used to fuse the bones or to lengthen the outside of the foot. Temporary instrumentation such as screws and plates can also be used to hold the bones together while they heal.
It?s time to take a long hard look at what?s in your closet. Now is the time to toss out shoes that are well worn. You also need to say good-bye to thin-soled shoes that offer zero arch support. If you?re overweight, fallen arches may be a sign the universe is trying to tell you something. You need to lose weight, and odds are, fallen arches are but one of many physical discomforts you are experiencing.