Flat Feet

What is flatfoot?

While a commonly known term, flatfoot is a complex foot problem with multiple causes, symptoms and treatments. There are several types of flatfoot, but they all share one common characteristic; a partial or total collapse of the arch. Other problems frequently occur with flatfoot, including toe drift, in which the toes and front part of the foot point outward. The heels tilt toward the outside and ankles appears to turn in. A tightening of the Achilles tendon is common, which causes the heel to lift off the ground earlier when walking which may make the problem worse. Also, bunions and hammertoes may develop.

Causes

There are several different causes of flatfoot, which include:

 

  • Hereditary factors - it is common for flat feet to run in families.

  • Weak arches - arches can collapse while standing or walking, even though the shape of the arch may return when sitting.

  • Injury - acute injuries can cause flat feet.

  • Arthritis / Rheumatoid Arthritis - a common cause in older patients.

  • Posterior Tibial Tendon - tears, ruptures and dysfunctions of this tendon can cause flatfoot. 

  • Nerve/Muscle Diseases - examples include; cerebral palsy, muscular dystrophy, or spina bifida.

  • Tarsal coalition - a condition where the bones of the foot fuse together, resulting in stiff and flat feet. This is commonly diagnosed during childhood.   

Symptoms

Symptoms that can occur in patient suffering from flatfoot include: 

  • Pain - in the arch, heel, ankle or running along the outside of the foot.

  • Overpronation - an excessive rolling inwards of the foot while walking. 

  • Shin Splints - pain along the shin.

  • Pain in other parts of the body - pain in the lower back, knees and hips is common with flatfoot. 

Treatments

Conservative treatments of flatfoot include:

  • Activity Changes - cutting back on long periods of walking or standing, or taking frequent breaks to sit.

  • Weight Loss - if the patient is overweight the physician will likely recommend diet and exercise to lose weight, as excessive weight buts more strain and pressure on the arches.

  • Orthotic Inserts - a custom orthotic device is frequently prescribed to aid in the support of the arch.

  • Immobilization - in certain circumstances your podiatrist may recommend a cast or walking boot. 

  • Oral Medications - Non-steroidal anti-inflammatory drugs (NSAIDs), such as aspirin or ibuprofen, may be used to reduce inflammation and pain.

  • Therapy - ultrasound and physical therapy may be prescribed to provide temporary relief.

  • Shoes - a change to supportive shoe gear, especially to a shoe which more aggressively supports the arch is recommended.  

  • AFO - an Ankle Foot Orthoses is a bracing device which helps control the motion of the foot.  

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