WHAT IS FLAT FEET?
By: Sara John, C.Ped (C)., C.Ped Tech (C)
Flat feet or pes planus is a condition where the arch of the foot is collapsed and the entire foot comes into contact with the ground completely or almost completely. It is also referred to as fallen arches. It can be congenital or acquired, and can affect either one or both feet. An easy way to detect flat feet is by performing a wet footprint test. Wet the feet in water and stand on a smooth level surface such as concrete or thin cardboard. The more the footprint on the surface, the flatter the foot.
The arch of the feet develops in infancy and early childhood as part of the normal growth of bones, muscles etc. It provides an elastic springy connection between the forefoot and the hind foot. During weight bearing, it helps dissipate the forces from the ground before it reaches the long bones of the lower leg.
Feet appear to be flat in infants because the arch is not fully developed and the baby fat covers the developing arch. The developed arch is seen in childhood and it progresses to proper arches in adolescence and adulthood.
Flat feet can develop in adults due to injury, illness, stress on foot, faulty biomechanics, aging etc. Obesity, pregnancy, diabetes also can result in adult acquired flatfoot. Other causes of pes planus include overuse – walking or standing for long hours, vigorous sports, non-supportive footwear, weakness of the structures of the foot etc.
If a person appears flatfooted while standing in a full weight bearing position, but an arch appears when seated or standing up on the toes, it is considered flexible flat foot. This is not a true collapsed arch. It is due to excessive rolling inwards of the foot (pronation). If the arch is absent in seated and standing position, it is considered as rigid flat foot. Most flexible flat feet are asymptomatic.
Flat feet can cause pain in the lower limb, back and hip as well. Plantar fascia strain, achilles tendon strain, bunions, leg fatigue are other symptoms. Children with flat feet or developing flat feet often complain about calf muscle pain, knee pain or arch pain. Limping, walking clumsily, pain or fatigue during long walks can be signs of flat feet.
Pedorthic treatment options include orthotics, supportive footwear, or modifications to footwear. Custom made orthotics support the skeleton, muscles and plantar fascia in the correct position. They are a long-term solution as they control and correct the mechanics that cause the problem. Stability / motion control footwear built with wide sole base that provide medial and lateral support can help lessen the pain and discomfort.
