What are the Causes, Symptoms and Treatment for Flat Feet or Fallen Arches?

Long gone is the day when the phrase flat feet was used as a comedy stalwart in variety shows and black and white movies, and equally gone is the automatic stigma that dictated that having flat feet would rule you out of a myriad of jobs, pastimes and activities.

However, flat feet can lead on to having severe pain if they are not managed properly, especially as people delay seeing a foot specialist until they are in intolerable pain. By this stage, damage to the foot may be problematic to rectify. You should see a foot specialist if any foot pain is distressful when walking, running or exercising. By treating your condition early, it may prevent you from getting further lower back, hip, leg, or knee pain in the future.

So if you want to know more, read on for the causes, symptoms and treatments for flat feet if they become painful…

What is Flat Feet?

You have a flat foot (also known as fallen arches or pes planus) if you have either no arch in your foot, or a very low arch, so all of your foot’s sole lies flat on the ground. Some people may have no issues with no arch, or a very low arch, while others will experience continual discomfort and pain. It may place a lot of pressure on the muscles and ligaments, resulting in pain in the back, hips, leg, knee or feet.

What causes Flat Feet?

The most common causes of flat feet include:

• Genetics as a parent can pass it to their children in their genes.
• Weakened arches where the arch is evident when the individual is sitting but when they stand the foot flattens to the ground.
• Foot or ankle injuries.
• Damaged, inflamed or torn tendons, especially the posterior tibial tendon.
• Conditions affecting the joints and soft tissues, including arthritis and rheumatoid arthritis.
• Nervous system or muscle diseases, such as cerebral palsy, muscular dystrophy, or spina bifida, where the muscles become stiffer and weaker over time.
• Tarsal coalition condition which causes the bones of the foot to fuse together abnormally, resulting in stiff and flat feet.
• The bones in the feet are not properly developed in the womb.

Other factors that may mean that an individual has the increased likely-hood of developing flat feet are:

• Obesity – The extra weight will place pressure on the tendons that support the arches. The arches may collapse as a result.
• High blood pressure – This may affect the tendons in the feet due to reduced blood supply.
• Diabetes – This affects the nerves in the feet and can give rise to tendon weakness.
• Pregnancy – Supportive ligaments are inclined to soften due a combination of extra weight and pregnancy hormones effects.
• Rheumatoid arthritis – This may affect the joints or weaken the tendons.
• Running – A long history of running may cause the posterior tibial tendon to weaken.
• Old age – Age increases the likely-hood of tendons weakening and stretching.
• Larger feet –  Individuals with larger feet are more susceptible to developing flat feet.

What are the symptoms?

Pain in the feet is the most common symptom associated with flat feet as the muscles and connecting ligaments are strained.

As time progresses, it may also affect other parts of the body notably the following:

• Lower back.
• Hips.
• Legs.
• Knees.
• Ankles.

You should always seek medical advise if any of the following symptoms appear:

• Your feet are hurting, are stiff, are weak or are numb.
• You have difficulty with your balance or walking.
• You have pain in your feet, ankles or legs or have suffered an injury.
• Your flat feet has only developed lately.
• Your symptoms do not improve with well-fitting footwear.
• One or both feet of your feet is flat.

How is Flat Feet diagnosed?

You can check if you have flat feet by undertaking the wet footprint test. This is accomplished by soaking the feet in water and standing on a smooth, level surface (e.g. smooth concrete or cardboard). Typically, the more the sole of your foot leaves a footprint, the flatter your foot.

A foot specialist will diagnose flat feet by examining the feet and observing the individual when they are standing and walking. They will also consider the individual’s medical history. In some cases, an X-ray, CT scan, or MRI scan may be ordered to confirm the prognosis.

How to treat Flat Feet?

Non-surgical Treatments

When you are worried about flat feet, please see your Medical Practice or Foot Specialist. They will offer you advice about:

• Supportive Footwear – Well-fitting footwear that can alleviate foot pain. Therefore, ensure you wear comfortable shoes that have low heels and are wide at the toe.
• Fitted Insoles – Insoles that can relieve pressure on the arch.
• Exercises – Exercises that can improve the flexibility and strength of the arch.
• Physiotherapy – Physio to improve walking abnormalities (gait) that exist due to the shape of the feet.
• Ankle Braces – These can be used if there is inflammation in the posterior tibial ligament or the cause of the flat feet is due to issues with the nervous system or muscle weakness.
• Rest and Ice – Use ice to reduce the pain and inflammation and rest until your symptoms improve.
• Avoid High Impact Activities – Do not undertake activities that will involve jumping and landing (e.g. basketball, netball) as this will irritate the feet.
• Lose Weight – This will reduce the strain on the arch.

Surgical Treatments

If necessary, flat foot surgery can be performed to relieve pain. An arch can be created where it had not existed before. No two surgeries are alike as the causes and location of the pain can differ. The surgery performed will depend on:

• The level of deformity.
• The severity of the symptoms.
• The patients age.
• Associated medical conditions.

There are two main surgery categories for flat feet treatment. Reconstructive surgery is the most regularly used, which repositions the tendons and fuses specific joints to accurately realign the foot. Subtalar implants is a procedure that is used to support the arch. Typically the flat foot is rectified with a metal implant placed in the back of the foot.