FLAT FOOT

Flat feet, medically known as pes planus, occur when the arches of the feet flatten, causing the entire sole to make contact with the ground when standing. While some individuals are born with flat feet (congenital pes planus), others develop the condition over time (acquired pes planus). Flat feet can be flexible, meaning the arch appears when the foot is lifted but flattens upon weight-bearing, or rigid, where the arch remains absent even when non-weight-bearing.

Causes of Flat Feet

Flat feet can result from a variety of factors, including:

1. Genetics: Congenital flat feet are often inherited. If your parents or siblings have flat feet, you may be more likely to develop them.
2. Weak Arch Muscles: Overuse, injury, or lack of conditioning in the muscles and ligaments supporting the arch can lead to its collapse.
3. Injuries: Trauma to the foot or ankle, such as tendon tears (e.g., posterior tibial tendon dysfunction), can cause acquired flat feet.
4. Medical Conditions: Conditions like rheumatoid arthritis, diabetes, or obesity can weaken the foot’s supportive structures, contributing to pes planus.
5. Aging: As we age, tendons and ligaments may lose elasticity, leading to a gradual flattening of the arch.
6. Pregnancy: Hormonal changes and weight gain during pregnancy can temporarily cause flat feet.

Symptoms of Flat Feet

Not all flat feet cause problems, and many individuals live active lives without discomfort. However, symptomatic flat feet may present with:

• Pain or aching in the feet, especially in the arch or heel
• Swelling along the inside of the ankle
• Difficulty standing for long periods or walking long distances
• Knee, hip, or lower back pain due to altered foot mechanics
• Fatigue in the feet or legs after physical activity
• Stiffness or reduced flexibility in the foot

Diagnosis

During your visit, our experienced doctors will perform a comprehensive assessment, which may include:

• Physical Examination: Observing your foot’s structure while standing, walking, and sitting to determine if the flat feet are flexible or rigid.
• Gait Analysis: Evaluating your walking pattern to identify biomechanical abnormalities.
• Imaging: X-rays, MRI, or CT scans may be ordered to assess bone alignment or soft tissue damage, particularly in cases of injury or severe deformity.

Treatment Options for Flat Feet

The good news is that flat feet can often be managed effectively with the right approach. Treatment depends on the severity, symptoms, and underlying cause. Here are the options I commonly recommend:

Non-Surgical Treatments

1. Custom Orthotics: Prescription shoe inserts can provide arch support, redistribute pressure, and correct abnormal foot mechanics. Over-the-counter arch supports may suffice for mild cases.
2. Supportive Footwear: Shoes with good arch support and a firm heel counter can stabilize the foot and reduce discomfort. Avoid minimalist or overly flexible shoes.
3. Physical Therapy: Exercises to strengthen the foot and ankle muscles, such as toe curls or calf stretches, can improve arch support and reduce pain.
4. Weight Management: Maintaining a healthy weight reduces stress on the feet, particularly for those with acquired flat feet.
5. Medications: Over-the-counter anti-inflammatory medications (e.g., ibuprofen) can help manage pain and swelling in symptomatic cases.
6. Activity Modification: Reducing high-impact activities or incorporating rest periods can alleviate symptoms.

Surgical Treatments

Surgery is typically reserved for severe cases where non-surgical treatments fail or when flat feet cause significant deformity or disability. Surgical options may include:

• Tendon Repair or Transfer: Addressing damaged tendons, such as the posterior tibial tendon, to restore arch support.
• Osteotomy: Realigning bones to correct foot structure.
• Arthrodesis: Fusing joints to stabilize the foot in cases of rigid flat feet or arthritis.
• Implant Devices: In select cases, a small implant may be used to support the arch (e.g., subtalar arthroereisis).

Conclusion

Flat feet are a common condition, but they don’t have to limit your lifestyle. With proper diagnosis and treatment, most patients can manage symptoms effectively and maintain an active, pain-free life. If you suspect you have flat feet or are experiencing discomfort, contact our office to schedule a consultation. Let’s work together to keep your feet healthy and strong!