Flat feet, medically called pes planus, occurs when the tendons, ligaments, and small bones in the sole of the foot cannot properly support the body and eventually fall. Flat feet are considered normal in developing infants and toddlers. With age, the veins in the soles of the feet tighten and produce shock-absorbing arches. Genetic predisposition, obesity, and the use of unsupportive footwear are contributing factors to flat feet, as occurs in about 25% of people in the US. In general, flat feet cause no symptoms or negative implications in adults. But for some people, flat feet cause back, calf, or leg pain and limit their ability to walk. Therefore, treating or treating flat feet is important.
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Method 1 of 3: Understanding the Types of Flat Feet
Step 1. Flat feet in children are normal
Children have flat feet until at least 5 years of age (sometimes up to 10 years) because the bones, ligaments, and tendons in the soles of the feet take time to form a supportive arch. So don't panic if your child has flat feet, especially if it doesn't cause pain and doesn't have a problem with walking or running. It will also go away on its own, so there is no need to seek treatment and try to fix it.
- Perform the test on a flat surface to test for flat feet. Wet the soles of your feet and step on a dry surface to see your footprints. If the entire surface of your foot can be seen clearly, you have flat feet.
- People with normal foot arches have a crescent-shaped negative space on the inside (middle) of their footprints due to lack of contact with the surface.
- Flat feet in children do not cause pain.
Step 2. Tight tendons can cause flat feet
A tight Achilles tendon (congenital) puts too much pressure on the forefoot, preventing the elastic arch from forming. The Achilles tendon connects the calf muscles to the heel. If this muscle is too tight, it will cause the heel to lift prematurely with each step of walking, causing tension and pain in the sole of the foot. In this case, the feet are flat when standing, but remain flexible when not bearing weight.
- The main treatment options for flexible flat feet with congenital short Achilles tendons can be aggressive stretching regimens or surgery, which are described in more detail below.
- In addition to heel and arch pain, other common symptoms of flat feet include: back and/or knee pain, ankle swelling, difficulty standing on tiptoes, difficulty jumping high or running fast.
Step 3. Stiff flat feet caused by bone deformities
Feet that are flat and rigid still have no arch whether or not they are weight bearing. This type is considered a "true" flat foot in the medical world because the shape of the foot does not change over time, regardless of any activity. This type of flat foot is usually caused by a malformation, deformity, or fusion that prevents the arch from forming as a child. Therefore, this type of flat foot can be congenital, or develop in adulthood due to an injury or disease, such as osteoporosis or inflammatory arthritis.
- Stiff flat feet usually produce more symptoms because the entire biomechanics of the foot changes.
- Rigid flat feet are the most resistant to accommodative therapies such as shoe inserts, orthotics, and physiotherapy.
Step 4. Flat feet that appear as adults are usually caused by obesity
Other types of flat feet are often referred to as adult-acquired, but are usually thought to be due to overstretching, overuse, or damage to the posterior tibial tendon, which starts from the calf muscle along the inside of the ankle and ends in the arch. These tendons are the most important soft arch tissue because they are the ones that support the most loads. The main cause of overstretching of the posterior tibial tendon is carrying too much weight (obesity) for a very long time, especially if you wear non-supportive footwear.
- Flat feet do not always occur in both feet (bilateral), it can occur in only one foot, especially after a fracture in the foot or ankle.
- Adult-acquired flat feet usually respond to accommodative therapy, but losing weight is key to correcting the problem.
Method 2 of 3: Fixing Flat Feet at Home
Step 1. Wear supportive shoes
Regardless of the type of flat foot you have, wearing shoes with good arch support will help a little, and may completely relieve your back, leg, or calf symptoms. Try to find athletic shoes with strong arch support. Supporting the arch of your foot will help reduce pressure on the Achilles tendon and posterior tibialis.
- Avoid heels more than 6 cm because it will cause the Achilles tendon to be short/tight. However, wearing shoes that are completely flat is also not recommended, as they put too much pressure on the heels. Use shoes with heels about to 1 cm.
- Try to buy shoes in the afternoon, because at that time your foot is growing in size, usually due to swelling and a little pressure on the arch of your foot.
Step 2. Order shoe inserts in your own size
If you have flexible flat feet (not really stiff) and spend a lot of time standing or walking, then consider getting your own sized shoe insert. Shoe inserts support the arch of your foot resulting in better biomechanics when standing, walking and running. By providing cushioning and shock absorption, shoe inserts will also help reduce the chances of the problem spreading to other joints such as the ankles, knees, waist, and lumbar spine.
- Shoe inserts and similar supports cannot reverse structural deformities in the foot nor can they reconstruct the arch of the foot simply by wearing them all the time.
- Health professionals who can make custom shoe inserts are podiatrists, as well as osteopaths, doctors, chiropractors, and physiotherapists.
- Wearing shoe inserts usually requires that the insoles of the factory default shoes be removed.
- Some health insurance plans cover manufacturing shoe inserts, but if your insurance doesn't have one, consider a ready-made orthopedic insole, which can be cheaper and provide support for the arch of the foot.
Step 3. Lose weight if you are too fat
If you are overweight, losing weight will provide other health benefits such as reducing stress on the bones, ligaments, and tendons in your feet, and improving blood circulation to your feet. Losing weight won't restore stiff flat feet, but it will have a positive impact on other types of flat feet and other benefits. For most women, consuming less than 2000 calories per day will lose weight per week even if you only do light exercise. Most men will lose weight within a week if they consume less than 2200 calories per day.
- Many obese people have flat feet and tend to overpronate their ankles (collapsed and bent joints), which results in a knock-knee (X-leg) posture.
- Sometimes the arch of the feet in women begins to decrease in the last trimester and disappears when the baby is born.
- To help lose weight, eat lean meat, chicken and fish, whole grains, fresh vegetables and fruits, and drink plenty of water. Avoid sugary drinks like soda.
Method 3 of 3: Seeking Medical Treatment
Step 1. Try some physical therapy
If your flat feet still have flexibility (not stiff) and are caused by weak or tight ligaments/tendons, you may consider several types of rehabilitation. A physiotherapist will show you specific, tailored stretches and exercises to strengthen your foot, Achilles tendon, and calf muscles to help restore the arch of your foot and make it more functional. Physiotherapy is usually required 2-3 times per week for 4-8 weeks to have a positive impact on chronic foot problems.
- A common stretch for a tight Achilles tendon is to place your hands against a wall with one leg extended behind you in a stance. Make sure you spread your flat foot on the floor to feel the stretch over your heel. Hold for 30 seconds and repeat 5-10 times per day.
- A physiotherapist will wrap your foot in a firm bandage to help relieve symptoms by providing an artificial arch.
- A physiotherapist can also treat fragile foot arches (called plantar faciits and a common complication of flat feet) with electrotherapy, such as therapeutic ultrasound.
Step 2. Consult a podiatrist
A podiatrist is a foot specialist who is familiar with all foot conditions and diseases, including pes planus. A podiatrist will examine your feet and try to determine if your flat feet are congenital or present in adulthood. They will also look for any bone trauma (broken or displaced bones), usually with the help of X-rays. The podiatrist will usually recommend simple palliative care (rest, ice, and anti-inflammatory for swelling), orthotic therapy, leg clamps, or some type of surgery., depending on how severe your symptoms and causes of flat feet are.
- Adult-acquired flat feet affect women 4x more often than men and tend to occur in old age (around their 60s).
- X-rays are also good for viewing bone problems, but can't diagnose soft tissues, such as tendons and ligaments.
- Your podiatrist is trained for relatively minor foot surgeries, but more complex operations are usually performed by an orthopedic doctor.
Step 3. Talk to your doctor about surgical options
If your flat feet are bothersome and shoes, shoe inserts, weight loss, or intensive physical therapy can't help, then ask your doctor about potential surgical options. Your doctor will use a CT scan, MRI, or ultrasound diagnostics to get a better look at the soft tissues in your feet. For severe cases of rigid flat feet, especially if they are caused by the tarsal coalition (abnormal fusion of two or more leg bones), then surgery is highly recommended. Surgery is also recommended for a chronically tight Achilles tendon (usually a simple procedure to lengthen the tendon) or an overly tight tibial tendon (by reducing or shortening it). Your family doctor is not a foot, bone, or joint specialist. So, you will likely be referred to an orthopedist if surgery is needed.
- Doctors will usually operate on the legs one at a time so as not to immobilize the patient and have a significant impact on their lives.
- Complications that may occur after surgery are: fused bones fail to heal, infection, limited leg/ankle movement, and chronic pain.
- Recovery time after surgery varies depending on the procedure (whether the bones need to be broken or fused, tendons severed, or ligaments changed), but can last several months.
- Diseases that are a contributing factor to flat feet are diabetes, osteoporosis, arthritis, and ligament laxity diseases such as Marfan syndrome or Ehlers-Danlos syndrome.
Tips
- Do not wear used shoes because the shape of the foot and the arch of the previous wearer is already formed in the shoe.
- Stiff and adult-acquired flat feet can cause severe pain and permanent foot deformity, so don't ignore this problem.
- Flat feet tend to run in families, which means flat feet are a partially inherited disease.
