Flat Feet

The medical term for “flat feet” is “pes planus” or sometimes we just call them “fallen arches. You are considered to have flat feet when the arches that give the foot its characteristic shape are flattened so that the whole sole of the foot touches the ground upon standing.

Having flat feet is very common and rarely does it hurt. You can be born with flat feet or you can develop it as you age with wear and tear on the feet while walking on them. Even though flat feet aren’t usually painful, they can cause problems with the alignment of the joints in your legs, particularly the knees and the ankles. Even if this happens, you may have no pain and there will be no treatment required.

Symptoms of Flat Feet

Many people have flat feet and don’t know it because they have no symptoms. They can wear regular shoes and can walk normally. In other cases, the flat feet can cause pain in the feet, particularly in the area of the arch or in the heel area. The pain might worsen when standing or walking on the feet or there can be swelling along the inner aspect of the ankle. You can have just one flat foot or both feet can be flat.

Causes of Flat Feet

It is normal to have a flat foot if you are a baby or a toddler because it takes a bit of aging before the arch becomes fully developed. Usually the arches form in childhood but, in some cases, this never happens and the foot or feet remain flat.

It is possible to have a flat foot that is flexible. This means that the child has a visible arch as long as the child is sitting down or standing on his or her tiptoes. As soon as the child stands directly on the floor, however, the arch disappears. As the child grows, the ligaments that create the arch become stronger and the flat foot disappears, leaving behind a normal arch.
​Adults can have flat feet even if they once had normal feet. People who are on their feet a lot will cause the ligaments that create the arch to weaken, causing the foot or feet to become flatter.

Risk Factors for Flat Feet

While you are usually born with flat feet, there can be reasons why you have flat feet as an adult. These include the following:

  • You can have an injury to the ankle or foot that disrupts the supporting ligaments of the foot arch.
  • You can be very overweight, which puts excess pressure on the arches to hold your body up.
  • You can suffer from rheumatoid arthritis, which deforms the joints of the foot, flattening out the foot in the process.
  • The incidence of flat feet increases as you age because the strength of the ligaments is not as great and the feet flatten out.

Diagnosing Flat Feet

Much of the diagnosis of flat feet involve the podiatrist examining your foot when you are sitting down and when you are standing on them. They can make a mold of the foot showing the flatness of the arch of the foot. The podiatrist will also look at your shoes to see how they have worn down over time as it is different with flat feet when compared to normal feet.
​In unusual circumstances, the podiatrist may use x-rays and the like to diagnose your problem. A plain x-ray of the foot may show arthritis of the foot as a cause of your flat feet. CT scanning can look at the foot in three dimensions and can see exactly where the bones are positioned. If the podiatrist believes you have an injured ligament or tendon, an ultrasound may be ordered of the foot to show what the soft tissues look like. MRI scanning will also show any abnormality of the bones and soft tissue of the foot but is rarely necessary.

Treatment of Flat Feet

If you have no pain, the podiatrist will likely not do anything about the fact that you have flat feet. If you are in pain, the podiatrist may recommend arch supports you can buy at the pharmacy or will make use of custom made arch supports. They won’t correct the problem but they can often lessen the pain. You may have flat feet because your Achilles tendon is too short. Exercises can be recommended to lengthen the Achilles tendon.
​The podiatrist may recommend that you wear a more supportive shoe. You will not be able to wear flip-flops or flat sandals without some kind of pain. If you are a runner who has suffered from flat feet due to repetitive pounding on the pavement, the podiatrist can take a video of you running to make suggestions that will help improve your running technique so the pain will be lessened. Surgery is not usually necessary to repair flat feet.

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