Flat Feet (Pes Planus): Causes, Symptoms, and Management

What Are Flat Feet?

Flat feet are a condition where the natural arch of the foot collapses or fails to develop, resulting in a foot that appears flat when standing. Flat feet may be:

• Flexible: Arches appear when the foot is off the ground but flatten when standing.

• Rigid: The arch is absent even when the foot is not weight-bearing.

Causes of Flat Feet

Congenital

• Hereditary Factors: Often present from birth due to genetic predisposition.

• Developmental Delay: Some children’s arches don’t form fully during growth.

Acquired

• Injury: Trauma to the foot or ankle, such as ligament damage or fractures.

• Tibialis Posterior Tendon Dysfunction: Weakness or tears in this tendon can lead to flat feet.

• Obesity: Increased weight places strain on the foot, contributing to arch collapse.

• Arthritis: Inflammatory conditions such as rheumatoid arthritis can weaken foot structures.

• Aging: Loss of elasticity and muscle strength over time may lead to flat feet.

Symptoms of Flat Feet

• Pain and Fatigue: In the arch, heel, or ankle, especially after standing or walking.

• Swelling: Along the inner side of the ankle.

• Altered Gait: Difficulty walking or changes in stride.

• Knee, Hip, or Back Pain: Caused by altered biomechanics from poor foot alignment.

• Shoe Wear Patterns: Uneven wear on the inner soles of shoes.

Diagnosis of Flat Feet

Clinical Examination

• Visual Assessment: Observing foot posture in weight-bearing and non-weight-bearing positions.

• Gait Analysis: Evaluating walking or running patterns for abnormalities.

Imaging

• X-rays: To assess bone alignment and detect joint issues.

• MRI or Ultrasound: To evaluate soft tissue damage, such as tibialis posterior tendon dysfunction.

• Foot Pressure Analysis: Determines weight distribution and pressure points on the foot.

Treatment for Flat Feet

Non-Surgical Management

1. Footwear

   • Supportive shoes with firm soles and arch support.

   • Avoid high heels or unsupportive footwear.

2. Orthotics

   • Custom-made insoles to support the arch and improve foot alignment.

3. Stretching and Strengthening Exercises

   • Calf Stretches: To reduce tension on the Achilles tendon.

   • Tibialis Posterior Exercises: To strengthen muscles supporting the arch.

   • Toe Curls and Heel Raises: To improve foot stability and function.

4. Weight Management

   • Reducing body weight to lessen strain on the feet.

5. Physiotherapy

   • Tailored exercise programs to address muscle imbalances and enhance foot biomechanics.

Surgical Options

Surgery is rare and reserved for severe cases or if conservative treatment fails. Procedures may include:

• Tendon Repair or Reconstruction: To correct tibialis posterior dysfunction.

• Osteotomy: Realigning bones in the foot to restore the arch.

• Arthrodesis: Fusing joints to stabilize the foot in extreme cases.

Living with Flat Feet

Most people with flat feet can lead active lives without complications. However, for those experiencing discomfort or related issues, treatment can significantly improve quality of life by:

• Reducing pain and fatigue.

• Enhancing posture and gait.

• Preventing secondary issues like arthritis or chronic joint pain.

Flat feet don’t have to hold you back. At Palms Physiotherapy & Allied Health, we specialize in effective, evidence-based treatments to help you manage symptoms and improve foot health. Contact us today to start your recovery journey.