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Pes Planus Explained

Overview

Acquired Flat Foot

Fallen arches is a common term used to describe a flatfoot condition that develops during adulthood. This should not be confused with other causes of flatfoot that may develop during childhood or adolescence. Most cases of ?fallen arches? develop when the main arch-supporting tendon (the posterior tibial tendon) becomes weakened or injured, causing the arch to gradually become lower. With time, the shape of the foot changes and secondary symptoms start to appear. Common problems associated with fallen arches include plantar fasciitis, tendonitis, increased fatigue, and arthritis of the foot and ankle.

Causes

As discussed above, many health conditions can create a painful flatfoot. Damage to the posterior tibial tendon is the most common cause of AAFD. The posterior tibial tendon is one of the most important tendons of the leg. It starts at a muscle in the calf, travels down the inside of the lower leg and attaches to the bones on the inside of the foot. The main function of this tendon is to hold up the arch and support your foot when you walk. If the tendon becomes inflamed or torn, the arch will slowly collapse. Women and people over 40 are more likely to develop problems with the posterior tibial tendon. Other risk factors include obesity, diabetes, and hypertension. Having flat feet since childhood increases the risk of developing a tear in the posterior tibial tendon. In addition, people who are involved in high impact sports, such as basketball, tennis, or soccer, may have tears of the tendon from repetitive use.

Symptoms

People will have a very heavily dropped arch and it won?t affect them at all and people will have it slightly dropped and it could cause fierce problems. It could cause things like plantar fasciitis, it could cause heel spurs, desperate ball-of-the-foot pressure, or pressure on the big toe known as the hallux which causes discomfort in the foot. It will create problems upwards to the knees, hips and the back once you?re out of line.

Diagnosis

Runners are often advised to get a gait analysis to determine what type of foot they have and so what kind of running shoe they require. This shouldn?t stop at runners. Anyone that plays sports could benefit from this assessment. Sports shoes such as football boots, astro trainers and squash trainers often have very poor arch support and so for the 60-80% of us who do overpronate or have flat feet they are left unsupported. A change of footwear or the insertion of arch support insoles or orthotics can make a massive difference to your risk of injury, to general aches and pains and even to your performance.

fallen arches support

Non Surgical Treatment

Treatment of flat feet by a fully educated, trained, and licensed podiatrist should be sought if the previously mentioned pain in the foot or knee areas start to surface and becomes a painful problem. Depending on the cause and exact type of the condition, a variety of forms of treatment may be prescribed. Verification of the exact cause and type of flat feet that each individual has, should only be handled by a professional podiatrist. Often times, the actual treatment method will include some form of arch support or light gymnastic style exercise. In rare cases, something more involved may be necessary, but only your skilled podiatrist would be able to accurately make that determination. If you suffer from flat feet, plantar fasciitis, or any other form of problematic foot condition, we encourage you to contact a foot clinic today and potentially rid yourself of that problem in virtually no time at all.

Surgical Treatment

Adult Acquired Flat Feet

Common indications for surgery are cerebral palsy with an equinovalgus foot, to prevent progression and breakdown of the midfoot. Rigid and painful Pes Planus. To prevent progression, eg with a Charcot joint. Tibialis posterior dysfunction, where non-surgical treatment is unsuccessful. Possible surgical procedures include Achilles tendon lengthening. Calcaneal osteotomy, to re-align the hindfoot. Reconstruction of the tibialis posterior tendon. For severe midfoot collapse of the arch, triple arthrodesis may be indicated.

Prevention

Sit up straight in a chair with your feet flat on the ground. Scrunch up the toes of one foot as if you are trying to grab hold of the floor then use your toes to drag your foot a small distance forwards. Do this a couple of times on each foot, but don?t use your leg muscles to push your foot forward -- the movement should come solely from the muscles in your feet. Sit in a chair and place a cleaning cloth, towel or small ball on the floor at your feet. Use the toes of one foot to grasp the object and lift it off the floor. This action will require you to clench your toes and contract your arch. Once you have lifted the object a little way off the floor, try to throw it in the air and catch it by stretching your toes and arch out and upwards. Repeat the exercise several times on both feet. Sit on the floor with your legs straight out in front of you then bend your knees out to either side and place the soles of your feet together so your legs form a diamond. Hold on to your ankles and, keeping your heels together at all times, separate your feet so your toes point out to either side. Open and close your feet in this way several times, making sure your little toes stay in contact with the floor throughout the exercise. Starting in the same position, try separating your heels, keeping your toes together at all times.