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The Treatment Of Pes Planus

July 2, 2017
Overview

Adult Acquired Flat Foot

Flat feet and fallen arches are common conditions that are in most cases asymptomatic. However, in patients who do have symptoms, treatments are available that can help reduce pain and promote efficient movement. Orthotic devices are well recognised as an excellent treatment and podiatrists can offer these different treatment modalities as individualised treatments for patients.

Causes

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

Symptoms

The primary symptom of fallen arches is painful or achy feet in the area in which the foot arches or on the heel. This area may become swollen and painful to stand still on. This causes the patient to improperly balance on their feet which in turn will cause other biomechanical injuries such as back, leg and knee pain.

Diagnosis

It is important for people with foot pain to know if they have flat feet. The following tests can help you determine your arch type. When you get out of a swimming pool, look at your footprint on the concrete. The front of the foot will be joined to the heel by a strip. If your foot is flat, then the strip is the same width as the front of the foot, creating a footprint that looks like a stretched out pancake. With a normal arch, the strip is about half the width of the front of the foot. If you have a high arch, only a thin strip connects the front of the foot with the heel. Put your shoes on a flat table and view them at eye level from behind. See if the sole is worn evenly. A flat foot will cause more wear on the inside of the sole, especially in the heel area. The shoe will easily rock side to side. A flat foot will also cause the upper part of the shoe to lean inward over the sole. Both shoes should wear about the same way. If you have pain in one foot, you should make sure you don't have a fallen arch on that side. There are two good tests you can perform at home to detect this problem. Place your fingertips on a wall that you are directly facing and stand on your tiptoes on one foot. If you can't do it, a fallen arch may be the culprit. Stand with your feet parallel. Have someone stand in back of you and look at your feet from behind. You can also do it yourself if you stand with your back to a mirror. Normally, only the pinky toe is visible from behind. If one foot is flatter than the other, the 4th and sometimes the 3rd toe on that foot can also be seen.

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Non Surgical Treatment

Most flexible flat feet are asymptomatic, and do not cause pain. In these cases, there is usually no cause for concern, and the condition may be considered a normal human variant. Flat feet were formerly a physical-health reason for service-rejection in many militaries. However, three military studies on asymptomatic adults (see section below), suggest that persons with asymptomatic flat feet are at least as tolerant of foot stress as the population with various grades of arch. Asymptomatic flat feet are no longer a service disqualification in the U.S. military.

Surgical Treatment

Adult Acquired Flat Feet

Surgery for flat feet is separated into three kinds: soft tissue procedures, bone cuts, and bone fusions. Depending on the severity of the flat foot, a person?s age, and whether or not the foot is stiff determines just how the foot can be fixed. In most cases a combination of procedures are performed. With flexible flat feet, surgery is geared at maintaining the motion of the foot and recreating the arch. Commonly this may involve tendon repairs along the inside of the foot to reinforce the main tendon that lifts the arch. When the bone collapse is significant, bone procedures are included to physically rebuild the arch, and realign the heel. The presence of bunions with flat feet is often contributing to the collapse and in most situations requires correction. With rigid flat feet, surgery is focused on restoring the shape of the foot through procedures that eliminate motion. In this case, motion does not exist pre-operatively, so realigning the foot is of utmost importance. The exception, are rigid flat feet due to tarsal coalition (fused segment of bone) in the back of the foot where freeing the blockage can restore function.

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