Fallen arches, or flatfoot, is a condition in which the arch on the inside of the foot is flat and the entire sole of the foot rests on the ground. It affects about 40 percent of the general population. Although flat feet in and of themselves are not usually problematic, they can create problems in the feet, hips, ankles and knees. Pain may be experienced in the lower legs if there are alignment problems and if the individual is engaged in a lot of heavy, high-impact activities that put stress on the bones and muscles of the lower legs.
The direct cause of being flat footed is linked to a muscular imbalance in the intrinsic muscles of the foot and ankle. When your main arch-supporting tendon, the posterior tibial tendon, decreases in strength due to muscle decay or injury, the foot begins to flatten and can cause pain during normal activities. Weakness in the tendon can be present at birth due to genetics or can develop from early walking patterns. However, in most people who experience fallen arches, it comes from strain due to aging or placed on the feet from standing or walking in heels for long periods of time. Improper footwear that doesn?t support the arch of the foot, diabetes and obesity can increase your risk of developing fallen arches.
Symptoms that should be checked by a pediatrician include foot pain, sores or pressure areas on the inner side of the foot, a stiff foot, limited side-to-side foot motion, or limited up-and-down ankle motion. For further treatment you should see a pediatric orthopedic surgeon or podiatrist experienced in childhood foot conditions.
You can always give yourself the ?wet test? described above to see whether you have flat feet. Most people who do not notice their flat feet or have no pain associated with them do not think to see a foot doctor. Flat feet can lead to additional problems such as stiffness or pain, however, especially if the condition appears out of nowhere. If you think you may have flat feet, you should seek medical attention to ensure there are no additional issues to worry about. Your doctor will be able to diagnose you with a number of tests. For example, he or she may have you walk around, stand still, or stand on your tiptoes while you are being examined. Your doctor may also examine your foot?s shape and functionality. It?s important to let your foot doctor know about your medical and family history. In some cases, your doctor may order imaging tests such as x-rays or an MRI (magnetic resonance imaging) to determine a cause of your flat foot. If tarsal coalition is suspected in children, a CT scan is often ordered.
pes planus radiology
Non Surgical Treatment
Treatment isn't usually needed for flat feet because the condition doesn't usually cause any significant problems. Aching feet can often be relieved by wearing supportive shoes that fit properly. You may need to wear shoes that are wider than normal. If your feet overpronate, you may need to wear a special insole (an orthotic) inside your shoes to stop your feet rolling inwards when you walk or run. These will usually need to be made and fitted by a podiatrist. Stretching your calf and Achilles tendon may also help as a tight Achilles can make your foot overpronate. To stretch your calf and Achilles tendon, step forwards with your left leg and bend it, with your right leg straight and both feet pointing forwards, push your right heel into the ground while keeping your right leg straight; you should feel the stretch at the back of your right leg, below the knee, hold the stretch for 15 to 30 seconds and repeat with the opposite leg, repeat the stretch two to four times on each leg, and repeat the overall exercise three to four times a day.
In cases of flat feet that have progressed substantially or have failed to improve with non-surgical treatment, surgery may be required and in some advanced cases, surgery may be the only option. Your foot and ankle surgeon will determine the best approach for you.
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 nonunion (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.