An adult foot has an inward curve on the inside known as an arch. The arches are made up of several tendons within your foot and lower leg.
When these tendons all pull together properly, your foot develops a normal arch, otherwise your foot will form low or no arch – a condition known as flat foot or fallen arch. Flat feet (pes planus), like other wonky feet conditions are no joke.
Their effects are crippling. The condition is, however, rather normal (and rarely painful) among infants and toddlers where it is caused by a an abnormality that develops in the womb in which two or more of the bones in the midfoot and hindfoot grow or fuse together i.e. tarsal coalition (The New York Times, Health Guide – Flat Feet, Thursday, October 9, 2014).
In this article, you are going to learn some of the major contributors, symptoms, relief and treatment options of flat arches. Read on.
Causes of Flat Feet
This abnormal connection develops between the tarsal bones (heel bone, cuboid, navicular, talus, and cuneiform bones) during fetal development. It is these bones that work together to provide you with the motion necessary for normal foot function. Tarsal coalition is the major cause of flat and stiff feet among infants and toddlers. It is often composed of bone, cartilage, or fibrous tissue, and usually leads to pain and limited motion in one or both feet. Obstetricians exclusively define tarsal coalition as a product of an error during the embryonic cells division in uterus.
Nervous system breakdown
Conditions that affect the brain and spinal cord can also cause a fall in your arches. Such conditions include muscular dystrophy, cerebral palsy and spinal bifida. They make the food muscles to become stiffer and weaker.
Flat feet is an autosomal dominant genetic condition that can be passed on from a parent to the offspring i.e. it is hereditary, and can be passed on through generations.
Biomechanical complaint (abnormal walking)
The most common biochemical complaint is the Fore Foot Varus, a condition in which the subtaler joint in your foot rolls in too much. In other words, it over pronates.
Illness, injury or traumatic events
Illness, aging or injuries may rupture your tendons and cause flat feet if you have already developed arches. According to Dr David Jones, a rheumatologist at London Bridge Hospital, “Flat feet is most likely to develop during activities, such as when you climb stairs or try to run.”
Other causes include:
- · Weak arches
- · Wear and tear on feet
- · Weakness and tightness muscles and tendons higher up in the lower extremity
Risk factors to Flat Feet
A risk factor is something that enhances the probability of a condition to develop. Some of the risk factors to a higher likelihood of developing flat feet include:
- · Obesity
- · Pregnancy
- · Diabetes
- · Bunions
- · Hammertoes
- · Foot or ankle injury
- · Rheumatoid arthritis
- · tendon rupture or dysfunction
- · Plantar fasciitis (pain and inflammation in the ligaments in the soles of feet)
Symptoms of Flat Feet
Symptoms often vary depending on the severity of the condition. However, the most common signs or symptoms of flat feet are:
- · Lowered or flat foot arch
- · Tired and achy feet
- · Ankle weakness and immobility
- · Foot pain mainly in the hip, calf, ankle, heel, and arch or lower leg areas making it difficult to stand on tiptoes
- · Swelling on the inside of the ankle
- · Shoes may not fit properly and may wear unevenly
- · A more-than-usual tiling of the heel away from the midline of your body
It is recommended that you see your doctor or a podiatrist immediately for an examination if you experience the symptoms mentioned above.
Flat Feet Treatment
Before treatment is done, your doctor or podiatrists will check whether your flat feet is the cause of discomfort or the result of poor conditioning.
If you experience no pain then no immediate treatment is necessary. However, if you engage yourself in extremely active activities such as running, a lot of walking playing soccer or being on your feet all day then you will need supportive well-fitted shoes or arch support insoles (or orthotics) to help prevent future injuries). Fitted insoles help reduce pressure from the arch and consequently relieve pain if your feet over-pronate.
If your doctor finds that you have tendonitis of the posterior tibial tendon, he/she may recommend a wedge to be inserted along the inside edge of the insole. This is done to help take some of the load off the tendon tissue. You will also be required to wear an ankle brace until the inflammation fades off.
If you have arthritis or ruptured tendon then a combination of an insole and painkillers such as ibuprofen will be of help to you. However, if the insoles and painkillers become ineffective then a surgical intervention may be performed.
If your bones or those of your children did not or are not developing properly then the only intervention will be a surgical procedure to separate and realign of the fused bones.
Rest – you may also be advised by your doctor to avoid activities which may worsen your condition. You will have to rest until the foot feels better.
Body weight management – If you are obese, your doctor will most likely advise that you lose weight.
Prior to flat feet treatment, it is important to let your doctor or podiatrist know about your medical and family history. After proper examination, the doctor may recommend an imaging test such as an x-ray or MRI (Magnetic Resonance Imaging) to determine the exact cause of your condition. In cases where tarsal coalition is suspected in children, a CT scan is often done.
Surgical procedures used to treat flat feet or fallen arches include:
- · Arthrodesis – Fusing together of one or more of your foot or anklebones
- · Excision – Removing a bone or a bone spur
- · Osteotomy – Realignment of bones by cutting and reshaping them
- · Synovectomy – Cleaning the sheath that encloses the tendons
- · Arthroereisis – Placing a small device in the subtalar joint to minimize motion
- · Tendon transfer – Re-attaching a tendon to another area of bone to reduce pronation and improve foot function
When treating flat feet, it is good to get to its root cause first. It should be treated depending on its cause, not based on the foot appearance. Signs may not be the cause of your discomfort. In some cases, the discomfort is a result of problems at the other parts of the leg. To help you learn more about how to fix flat feet, watch this YouTube video: