Flat Feet

Flat feet or Pes Planus is when the arches of your feet become flat as soon as you stand up from a sitting position. Having flat feet is very common. In fact, up to 22% of Canadians have flat feet. One in ten of these people will have foot pain or soreness. This condition is usually hereditary but can also be caused by pregnancy, aging, arthritis, obesity, injury, or another disease, such as muscular dystrophy, cerebral palsy, or spina bifida.

     Since all of your weight-bearing joints are connected, that means your back, hips, knees, ankles, and feet, a deformity of the feet affects all the rest of these joints. Pain and imbalance in your feet will lead to pain in other joints as well as gait and postural changes. Working to correct flat feet will bring your body into alignment and help correct other problems caused by having flat feet.

     It is normal for infants to have flat feet. Children 2-3 years old usually develop non-flattening arches as the tendons and ligaments in the feet tighten. Common categories of flat feet are: posterior tibial tendon dysfunction, tight Achilles tendon, and flexible flat foot.

     Flexible Flat Foot is the least problematic and most common of the three. It begins in childhood and is characterized by an arch present only when feet are lifted above the ground, when on the ground the arch falls flat. A tendon connects muscle to a bone. Achilles tendon connects gastrocnemeus (your calf muscle) to calcaneus (your heel bone) directly behind your heel. Having flat feet leads to tightness in this tendon, which in turn leads to soreness and pain when walking and running. To compensate and prevent further pain, the heel can lift prematurely when weight bearing.

     Posterior tibial tendon connects tibialis posterior muscle in the back of your leg and navicular (a bone in the arch of the foot). It supports the arch of the foot and helps to turn the foot in. Posterior Tibial Tendon Dysfunction can occur once there is an injury, tear, or swelling in the posterior tibial tendon. It is characterized by pain on the inside of the foot and ankle and on the outside of the ankle. This can happen in one or both feet. Diagnosis is made through obtaining family history, foot examination, and MRI.

     Common symptoms associated with flat feet are aching when walking or standing for a long time, pain in the ankles and lower legs, callouses, numbness, and stiffness. If you don’t experience any discomfort but you have flat feet, treatment may not be necessary. If you’re experiencing any of the above symptoms, see a pedorthist, chiropodist, or podiatrist. You will need orthoses, proper footwear, and footwear modifications. Non-steroidal anti-inflammatory medications for pain and inflammation and/or physiotherapy may be prescribed by a foot care professional. In extreme cases surgery may be indicated.

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