Flat Feet – Causes, Symptoms & Treatment

Overview  

Our foot’s sole is often a neglected part of our body’s anatomy. Like any other part of our bodies, our feet are susceptible to deformities or diseases like flat feet. People of all ages frequently experience the symptoms of flat feet. The flatfoot issue affects more than 30% of people worldwide.  

Flat feet, also known as pes planus or fallen arches, are postural deformities in which the sole of the foot makes full or almost full contact with the ground due to a lack of space between it and the floor.  

A child may have flat feet on one or both of its feet. Children who have flat feet experience abnormal wear and tear of shoes. But, each individual’s experience with flat feet is unique. While some kids with flat feet exhibit no symptoms, others complain of pain. The condition also occurs in adults.

While standing, the bottoms of the foot pads contact the ground. Usually, a foot’s arch cannot be seen, but occasionally, while lifting the foot, the arch becomes visible.  

Flat feet are seen in all newborns. By the age of six, arches often begin to emerge. Most children still have flat feet as adults—about two out of ten. Arches collapse in some adults. Flatfoot is also referred to as falling arches.

Most people do not have issues with flat feet. Treatments are available if flat feet are the cause of discomfort or other problems.

Symptoms of flat feet  

The loss or absence of an arch in the foot (particularly while bearing weight) and soreness or fatigue along the inner side of the foot and arch are the most noticeable signs and symptoms of flat feet.

Flat feet can result in several complications, such as

• Inflammation of soft tissue
• Shin splints
• Bunions
• Hammertoe
• Arthritis
• Plantar fasciitis
• Fatigue in the legs, arch, and feet
• Pain in the ankle, foot and heels
• Pain in the lower back, hips and knees
• Rolled-in ankles
• Irregular walking styles
• Posterior tibial tendon dysfunction (PTTD).

What causes flat feet?  

Flat feet can be congenital (present at birth) or acquired (the result of age or injury).

Congenital flat feet – Infants and toddlers frequently experience flat feet issues. The reason behind this is that throughout early life, foot arches do not fully develop. Most people eventually develop these arches. However, if they don’t, congenital flat feet occur.

Genetics or underlying medical issues like cerebral palsy can cause flat feet in children. Most children get flexible flat feet (the arch is visible when the person is sitting, but it disappears on standing). Some kids never grow out of flat feet, while others do so more slowly.

Children frequently have flat feet, which are frequently caused by,

• Heredity.
• Tight Achilles tendon
• Laxity of ligaments
• Lack of foot exercise.

A child’s arches typically start to form in infancy and evolve into normal arches in accordance with normal growth patterns.

Acquired flat feet – Acquired flat feet are a disorder that develops over time as a person ages. The posterior tibial tendon plays a major role in supporting the arch of our feet.  

Due to repeated, intensive use as we age, this tendon has inflammation and tear. Long-term overuse can harm the arch, which in turn causes flat feet in adulthood.

Adults with flat feet may result from

• Age
• Obesity
• Diabetes
• Pregnancy
• Scoliosis
• Marfan syndrome
• Injury or fracture
• Ankle and foot pain
• Strain and overuse
• Failed or injured tendons
• Arthritis
• Nervous system or muscular illnesses such as cerebral palsy, spina bifida.

Adults may have flat feet as a result of injury, a tight Achilles tendon, abnormal joint formation, continuous pressure on the foot’s arch, or just ageing.

Types of flat feet  

Whether flatfoot emerges during adulthood or is congenital (from birth), this can be an issue. The types of flatfoot include,

Flexible  

Flat feet are most frequently flexible. While being seated, one can see the foot arches. Putting weight on foot causes the arches to disappear. Young children or teenagers develop flexible flatfoot. Both feet are affected, and it increasingly worsens with age. The tendons and ligaments of the foot arches are prone to swelling, stretching and tearing.

Rigid

When standing (placing weight on the feet) or sitting, a person with rigid flat feet has no arches (no weight on the feet). This condition frequently starts while a person is a teenager and gets worse as they age. That could hurt the feet. Moving the feet side to side or up and down can be challenging.

Diagnosing flat feet  

While flat feet are usually self-diagnosis-able, a podiatrist may be needed to determine the underlying reason. Diagnosis requires both a visual examination and imaging studies to assess the foot’s structural integrity.

Visual examination

Usually, a podiatrist can identify flat feet by examining the feet while the patient is standing.  

• Wet footprint test – When performing the wet footprint test, one must wet their feet and stand on a flat, smooth surface. The flatter the foot, the thicker the print between the heel and ball of the foot. A high-arch foot, on the other hand, would only leave a little outer footprint.

• Shoe inspection – The test for shoe inspection may reveal signs of poor foot mechanics. More wear will be seen on the inside of the sole if there is a flat foot, especially towards the heel. The upper of the shoe will also incline towards the sole and inward.

• The healthcare professional counts the number of toes that are popping out to the sides while standing behind the patient while undergoing the too many toes test. In those with usual pronation, only the pinky toe would be visible, but in people who overpronate, three or four, maybe.

• The tiptoe test is performed to determine if the flat feet are flexible or rigid. A person has flexible flat feet if, while standing on the toes, a clear arch appears.

X-rays and other imaging tests  

When a patient frequently experiences foot discomfort, the doctor may prescribe imaging tests to assist in identifying the underlying cause. The imaging procedures used include,

• Ultrasound – Soft tissue injury, such as a ruptured tendon, can be captured in depth by ultrasound.

• X-rays and computed tomography (CT) scans – These are the best imaging techniques for diagnosing arthritis and assessing changes in the angle or alignment of the foot bones.

• MRI – For persons with rheumatoid arthritis, tendinitis or an Achilles heel injury, magnetic resonance imaging (MRI) can offer precise images of the damage to the bone and soft tissues.

Treating flat foot  

There isn’t much cause for concern unless there is a large amount of pain or other foot, ankle and limb abnormalities that are directly related to the flat feet. But, there are treatment alternatives available for people of all ages experiencing pain.

Children

Examining flat feet in children is the initial step in treating them. Parents and other adults who care for children should keep an eye on them in their early years to ensure appropriate arch development, as children are less aware of such things than adults are.  

Children should have a quick podiatric examination if any abnormalities are found.

To identify the kind and underlying causes of the majority of flatfoot deformities, podiatric specialists will perform both a clinical examination and an X-ray.

Adults  

The following nonsurgical procedures are available to prevent the onset of flat feet and their associated symptoms.

• Exercises
• Physical exercise
• Weight loss
• Rest
• Orthotics
• Bracing and supports
• Footwear with support
• Lifestyle modifications
• Medication.

Surgery can be the next step if nonsurgical remedies don’t help to alleviate the aches, pains and problems caused by flat feet.

Shoes for flat feet

Poorly fitted shoes might, in rare instances, cause flat feet or worsen the symptoms. A healthcare professional helps in finding the best flat-footed shoes with arch support.  

Exercises

These exercises are designed to reduce the discomfort and other symptoms brought on by this disease. To improve strength and flexibility in the feet and ankles as part of treatment, a healthcare professional will assist in performing stretching and strengthening exercises. The stretching of the heel chord and the golf ball roll are two frequent workouts.

Physical therapy

Physiotherapy is a successful method for treating musculoskeletal issues, such as flat feet. Those who actively participate in sports or demanding physical activities are strongly advised to get physical therapy.

Arch support

One of the many treatments recommended by specialists for flat feet is arch support. Arch supports are unique orthopaedic medical devices that help to reduce the symptoms of flat feet.

Medication

To help reduce the pain and symptoms, a healthcare professional may also recommend appropriate medications in addition to lifestyle modifications.

Surgery  

Flat foot surgery can offer long-lasting pain relief and might even add an arch where there was none. No two procedures are ever comparable since the sources and locations of pain can differ.  

The patient’s age, symptoms and the kind of structural deformity a person has will ultimately determine the surgical plan.

To treat flat feet, there are primarily two surgical approaches.  

• Reconstructive surgery – This is the most frequent procedure that realigns the foot appropriately by repositioning the tendons and fusing some joints.  

• Subtalar implant – The treatment supports the arch with a subtalar implant. For the purpose of treating flat feet, a metal implant is inserted into the back of the foot.

Home remedies  

Here are certain remedies for flat foot.

• Rest – Take rest as much as possible. Avoid unnecessary physical activity as it will make the feet hurt more. Instead, give the foot some rest and massage ice into the sore spots.
• Maintain a healthy weight – For a person experiencing recent pain and suffering from flatfoot, losing excess weight is helpful to prevent problems.
• Replace worn-out shoes – The pain may be made worse by using worn-out shoes. Get specially designed shoes with arch support if a person starts to feel pain and discomfort in the feet.

Conclusion  

Everyone has flat feet at birth. Usually, arches start to form by age 6. In some cases, flat feet develop in teenage or adults.

It’s possible that one will feel pain while walking. See a medical professional if flat feet cause pain. Stretching exercises and orthotics are nonsurgical treatments that help reduce discomfort and inflammation. Rarely, one might require surgery.

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