Also known as fallen arches, the condition of flat feet is characterized by a lack of appropriate arch in the inner foot. It can be a genetic condition or the result of improper body mechanics. Often the whole of the foot will contact the ground. Because a healthy foot is structurally able to support the weight of the body thanks to the bone structure that comprises the arch, a flat foot often is unable to properly support this weight and will cause extreme pressure in the joints above, such as the ankles, knees and hips.
Aging, injury, overuse, or illness can result in fallen arches or a fallen arch on one side. Diabetes. Obesity. Pregnancy. Nerve conditions. Foot abnormalities present since birth. Broken or dislocated bones in the foot. Stretched or torn tendons. Medical conditions such as arthritis. Sudden weight gain
A significant number of people with fallen arches (flat feet) experience no pain and have no problems. Some, however, may experience pain in their feet, especially when the connecting ligaments and muscles are strained. The leg joints may also be affected, resulting in pain. If the ankles turn inwards because of flat feet the most likely affected areas will be the feet, ankles and knees. Some people have flat feet because of a developmental fault during childhood, while others may find that the problem develops as they age, or after a pregnancy. There are some simple devices which may prevent the complications of flat feet.
Your doctor examines your feet to determine two things, whether you have flat feet and the cause or causes. An exam may include the following steps, Checking your health history for evidence of illnesses or injuries that could be linked to flat feet or fallen arches, Looking at the soles of your shoes for unusual wear patterns, Observing the feet and legs as you stand and do simple movements, such as raising up on your toes, Testing the strength of muscles and tendons, including other tendons in the feet and legs, such as the Achilles tendon or the posterior tibial tendon, Taking X-rays or an MRI of your feet.
Non Surgical Treatment
If you have fallen arches, but you are not experiencing any symptoms, then you probably do not need to seek treatment. If you are experiencing discomfort due to fallen arches, there are several treatment options. These treatment options include elevating the feet and applying ice to ease discomfort and reduce swelling, rest, exercises to stretch the feet, physical therapy, medication, such as anti-inflammatories, steroid injections and orthotic devices or customised arch supportsto wear in the shoes. If you have fallen arches and periodically experience pain related to that condition, it is a good idea to get orthotic devicesor custom arch supports, to wear in your shoes. The other treatment options, like medication and ice, will help to ease pain from fallen arches after you have already begun to experience pain. However, orthotic devices or(custom arch supports)can help to prevent pain from occurring at all. This preventative measure helps many people with fallen arches to avoid pain and prevent worsening of their condition. In severe cases of fallen arches, surgery may be required to correct the problem. You can also help to prevent pain and exacerbation of fallen arches by reducing your risk factors. If you are overweight, try to lose weight. Even a small weight loss can reduce the pressure on your feet significantly. If you are diabetic, manage your blood sugar as best as possible. Losing weight often also improves the condition of diabetics. You should also avoid high-impact activities, like running on the road, tennis, and sports that involve jumping. Try a gentler form of exercise, like swimming, instead. If you have fallen arches, orthotic devices or(custom arch supports)are an important component of your treatment and can help to prevent pain.
Surgery is typically offered as a last resort in people with significant pain that is resistant to other therapies. The treatment of a rigid flatfoot depends on its cause. Congenital vertical talus. Your doctor may suggest a trial of serial casting. The foot is placed in a cast and the cast is changed frequently to reposition the foot gradually. However, this generally has a low success rate. Most people ultimately need surgery to correct the problem. Tarsal coalition. Treatment depends on your age, extent of bone fusion and severity of symptoms. For milder cases, your doctor may recommend nonsurgical treatment with shoe inserts, wrapping of the foot with supportive straps or temporarily immobilizing the foot in a cast. For more severe cases, surgery is necessary to relieve pain and improve the flexibility of the foot. Lateral subtalar dislocation. The goal is to move the dislocated bone back into place as soon as possible. If there is no open wound, the doctor may push the bone back into proper alignment without making an incision. Anesthesia is usually given before this treatment. Once this is accomplished, a short leg cast must be worn for about four weeks to help stabilize the joint permanently. About 15% to 20% of people with lateral subtalar dislocation must be treated with surgery to reposition the dislocated bone.
Orthotic inserts, either prescribed or bought over the counter, can help keep the arches fixed into position, but always wear them as although they support, they don?t strengthen, which is why some experts reccomend avoiding them. Gait analysis at a run specialist can help to diagnose overpronation and flat feet. Most brands produce shoes that will give support and help to limit the negative effects of a poor gait on the rest of the body. Barefoot exercises, such as standing on a towel and making fists with the toes, can help to strengthen the arches. Start easy and build up the reps to avoid cramping. Short barefoot running sessions can help take pressure off the arches by using the natural elasticity of the foot?s tendons to take impact and build strength to help prevent flat feet. These should be done on grass for only a few minutes at a time.
Patients may go home the day of surgery or they may require an overnight hospital stay. The leg will be placed in a splint or cast and should be kept elevated for the first two weeks. At that point, sutures are removed. A new cast or a removable boot is then placed. It is important that patients do not put any weight on the corrected foot for six to eight weeks following the operation. Patients may begin bearing weight at eight weeks and usually progress to full weightbearing by 10 to 12 weeks. For some patients, weightbearing requires additional time. After 12 weeks, patients commonly can transition to wearing a shoe. Inserts and ankle braces are often used. Physical therapy may be recommended. There are complications that relate to surgery in general. These include the risks associated with anesthesia, infection, damage to nerves and blood vessels, and bleeding or blood clots. Complications following flatfoot surgery may include wound breakdown or non-union (incomplete healing of the bones). These complications often can be prevented with proper wound care and rehabilitation. Occasionally, patients may notice some discomfort due to prominent hardware. Removal of hardware can be done at a later time if this is an issue. The overall complication rates for flatfoot surgery are low.