Pes Planus, or colloquially called flat feet, is a type of deformity which alters the arches of the foot, where the entire sole of the feet comes into total or almost complete contact with the floor. Flat feet affects about 20 to 30% of the population, with the deformity affecting a single foot or both feet.
The arch in the foot provides an elastic, almost springy connection between the different parts of the feet and the forces enacted on it when you are in motion. For those who are suffering from flat feet, their talus bone is displaced along the middle, causing the spring ligament and the tendons to stretch so much that the person loses the function of the medial longitudinal arch. With a malfunctioning arch, the flat feet sufferer suffers from a rigid flat foot.
Flat Foot Symptoms To Look For
It’s worth noting that most people who suffer from flat feet do not suffer from any acute pain. However, the flat fee can contribute to structural problems in the ankles and knees because the condition can alter the alignment of your legs over time. Typically symptoms manifest themselves as:
- Foot pain particularly in the heel.
- Numbing pain in the arch area after prolonged walking or standing.
- Pain worsening with activity.
- Swelling on the inside of the ankle.
There are a few risk factors you should be aware of. Research has shown that people who suffer from flat feet show increased activity of a type of proteolytic enzymes. These enzymes break down the proteins into amino acids within the foot.
While the enzymes serve its purpose as a type of regulation of some physiological processes, proteolytic enzymes break down the tendons involved within it the arch of your foot causing the arch to fail eventually.
Other risk factors that may increase the propensity of flat feet is obesity. The sheer weight of the body can cause flat feet over time and a deterioration of the tendons. Injury to the foot in the ankle area increases the chances of flat feet as well. Diabetes and old age will also contribute to it.
Do Flat Feet Affect the Back?
Hip and knee and lower back pain are also synonymous with those who are suffering from flat feet. Instability from poor gait and posture stress the joints on your spine, knees, and hips. Over time, simple movements may become unbearable as you will experience arthritis-like symptoms that further limits the range of motion. If left untreated, flat feet can affect how you walk and run.
Flat Feet and Infants
You might be wondering if the flat feet affects children — flat feet in newborns and very young children is normal because of the lack of development in the arches. Most children develop these arches the age of six, with some experiencing delays or deformities that adversely affect normal alignment and development of the bones within the feet.
Children who suffer from genetic disorders like congenital vertical talus, hypermobility, and tarsal coalitions are at risk of developing flat feet or are the precursors to it.
What Causes Flat Feet?
Some of the more common causes of flat include genetic factors that cause flat feet to have a more uniform and flush interaction with the floor. A weak arch can also cause flat feet. Foot or ankle injury and rheumatoid arthritis are also contributing factors.
For adults, flat feet is typically about the deterioration of the tibial tendon. Women over the age of 50 and those who are obese are at risk. Some of the conditions that are linked to adult acquired flat feet include leg length inequality.
This usually arises from leg length discrepancies after hip replacement. Pregnancy can also cause it in adults — typically it is temporary due to increased production of elastin, a type of protein. Scoliosis is the obtuse curvature of the spine and can cause an unstable gait, leading to a one-sided phenomenon with one foot.
Do Shoes Contribute to Flat Feet?
A compressed toolbox which prevents the toes from spreading normally can elevate the heel and cause hyperextension. The result is the deterioration of the ankle over time, undermining the strength and stability of the foot. Unfortunately, fallen arches due to poor shoe fitting are typically permanent.
How are Flat Feet Diagnosed?
Typically flat feet is a self-diagnosed, but the doctor can pinpoint the issues that might have contributed to its formation. This may include a visual exam of the foot as well as a close evaluation of your gait.
The doctor will typically start with a visual examination which includes a wet footprint test. The thicker the print between the heel and the ball of the foot, the flatter the foot. Then a shoe infection tests will be done to pinpoint any faulty shoe mechanics that might be contributing to the flat feet.
Finally, tiptoe tests will be performed. This is used to measure the flexibility and the rigidity of your flat feet. If a visible arc forms when you stand on your tippy toes, you have flexible flat feet. If not, then your doctor will typically prescribe treatment.
For those who are suffering from acute pain due to the flat feet, the doctor will order several imaging tests like x-rays and computed tomography tests. This will diagnose arthritis and evaluate any irregularities within the foot’s structure.
An MRI scan will also be carried out if the x-ray was not able to adequately expose the causes of your flat feet. MRI scans are recommended for those who are suffering from rheumatoid arthritis or some Achilles heel injury.
Most people who suffer from flat feet will not experience any pain. In these cases, there is no cause for concern, and additional treatment isn’t needed nor required.
While flat feet used to be a marker to reject those who wanted to serve in the military, studies have shown that most asymptomatic sufferers — those are suffering from flat feet that do not experience any pain — can experience the typical tolerances of a normal feet, with this sort of flat fee no longer being a disqualifier for those who want to serve in the military.
However, keep in mind the painful flat feet — or symptomatic flat feet — can be a cause of concern and is a viable disqualifier during the enlistment process.
As mentioned, children tend to have flat feet naturally and do not need any intervention. To err the side of prevention, it’s worth noting that going barefoot on different types of terrain can help develop normal arch development, especially between the critical ages of four and six.
On the other hand, having your child constantly wearing closed-toe shoes can potentially increase the risk of subpar ligament development. Simply allowing your kid to run around in the grass or on your home floor with no additional footwear can be beneficial in developing a strong foot with no issues.
For adults, flatfoot can be a problem. Thankfully several nonsurgical treatments can be very effective in managing pain.
Only about 20% of those who experience flat feet will have pain. This pain is larger localized and can be treated with the local pain relievers like acetaminophen. However, for those who experience extreme discomfort, they would need orthotic support to help reinforce the structure of their foot. These supports will increase, layer by layer, allowing the foot to adapt to the sensation gradually.
Additional treatments include exercises to improve arch flexibility. Foot gymnastics that involves stimulating the muscles inside of the foot can be helpful. Exercises that require intrinsic movements with the toes like picking up marbles with your feet or stacking items with your toes can also help. A runner’s stretch that strengthens the calf muscle and Achilles tendon can help alleviate tightness and discomfort.
Extreme Fixes and Treatment: Is Surgery Necessary?
If needed, additional surgery will provide lasting pain relief and can help you create an arch. Keep in mind that this is usually the last ditch effort scenario to help remediate crippling pain. One type of surgery involves the insertion of an implant on the back of the foot for additional support.
This reconstructive surgery will position a tendon and certain adjacent joints to realign the foot. While it can be helpful, surgery needs careful contemplation since the recovery process can be long and costly.
Coping with Flat Feet
For those who do not suffer from debilitating pain, then there are different ways to manage and cope with having flat feet. Make stretching a daily part of your daily routine. Equinus, a type of tight muscle that affects the calves, is one of the main causes of flat feet. You can prevent those by stretching regularly.
Shoe inserts or arch supports can also raise your foot. The work by slowly realigning the structure of the foot to a more comfortable position, raising the arch and inverting the heel bone. One of the main benefits is the immediate relief: the inserts alleviates pressure and muscles contractions almost immediately.
Also, one of the best ways to help prevent worsening flat feet is by going barefoot. When walking or training barefoot, the muscles in your foot are a lot more engaged and grow stronger over time. Stronger feet is associated with augmented stabilization.
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