Flat feet (also called pes planus or fallen arches) is a postural deformity in which the arch of the foot collapses, with the entire sole of the foot coming into complete or near-complete contact with the ground. Some individuals (an estimated 20-30% of the general population) have an arch that simply never develops in one foot (unilaterally) or both feet (bilaterally).
Causes
As discussed above, many health conditions can create a painful flatfoot. Damage to the posterior tibial tendon is the most common cause of AAFD. The posterior tibial tendon is one of the most important tendons of the leg. It starts at a muscle in the calf, travels down the inside of the lower leg and attaches to the bones on the inside of the foot. The main function of this tendon is to hold up the arch and support your foot when you walk. If the tendon becomes inflamed or torn, the arch will slowly collapse. Women and people over 40 are more likely to develop problems with the posterior tibial tendon. Other risk factors include obesity, diabetes, and hypertension. Having flat feet since childhood increases the risk of developing a tear in the posterior tibial tendon. In addition, people who are involved in high impact sports, such as basketball, tennis, or soccer, may have tears of the tendon from repetitive use.
Symptoms
Many people have flat feet and notice no problems and require no treatment. But others may experience the following symptoms, Feet tire easily, painful or achy feet, especially in the areas of the arches and heels, the inside bottom of your feet become swollen, foot movement, such as standing on your toes, is difficult, back and leg pain, If you notice any of these symptoms, it's time for a trip to the doctor.
Diagnosis
If you notice that your feet are flat, but you?re not really experiencing any pain, then you?re probably okay to go without a visit to the podiatrist (unless, of course, you have a lack of feeling in your foot). You can schedule a hair appointment instead, or maybe see a movie. However, once painful symptoms start to appear, it?s better to skip the hirsute (or cinematic) experience and go see your foot doctor. Your podiatrist will likely make the diagnosis by examining your foot visually, asking about symptoms you may be experiencing, and may test your muscle strength. You may be asked to stand on your toes (in a ballerina pose, if you prefer, although that?s certainly not required), or walk around the examining room, and you may need to show the podiatrist your shoes. He or she may comment on your excellent taste in footwear, but is more likely to check your shoes for signs of wear that may indicate fallen arches. Your podiatrist may recommend X-rays, a CT scan or an MRI in order to get a look at the interior of your foot, although the best diagnosis usually comes from the doctor?s own in-person examination.
Non Surgical Treatment
If your condition is bothersome, try elevating your feet and using ice on the arches to reduce swelling. Your podiatrist can recommend several orthotic aids and inserts to strengthen the tendons of your foot. He can also demonstrate stretching exercises or refer you to physical therapy to get those tendons back into shape. If the symptoms of fallen arches are painful and troubling, he may recommend a steroid injection to relieve inflammation and pain. And in some instances, he may determine that surgery is necessary.
Surgical Treatment
This is rare and usually only offered if patients have significant abnormalities in their bones or muscles. Treatments include joint fusion, reshaping the bones in the foot, and occasionally moving around tendons in the foot to help balance out the stresses (called tendon transfer). Flat feet and fallen arches are common conditions that are in most cases asymptomatic. However, in patients who do have symptoms, treatments are available that can help reduce pain and promote efficient movement. Orthotic devices are well recognised as an excellent treatment and podiatrists can offer these different treatment modalities as individualised treatments for patients.
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