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What Are Flat Feet?

Flat feet are a condition characterized by the arches of one or both of your feet dropping or becoming flat, increasing the surface area of your foot touching the floor. When weight is applied to the foot, a loss of arch height is visible but usually doesn't prove to be a serious problem for your health.  

Children's feet usually lack arches, but they should develop as they grow and start to bear weight on the feet. Should the arches not develop, they will usually remain flat into adulthood. Increasing physical activity may cause pain to arise due to the altered biomechanics of the foot and lower leg.

Flat feet are usually diagnosed by observation of the arch itself during sitting, standing, and walking. A medical professional may request X-rays to assess the bone structure of the feet. 

Summary of Important Points

  • Loss of arch height 
  • Increased surface area of the foot in contact with the floor
  • Starts in childhood and is usually outgrown  
  • Caused by genetics or sudden onset loss of arch height 
  • Not everyone will experience symptoms of pain
  • May cause mobility and gait issues 
  • Symptoms may worsen with activity 

Symptoms of Flat Feet

Flat feet are usually identified visually through a loss of arch height when standing. Pain and fatigue in the muscles of the foot are primary symptoms of flat feet. 

Other symptoms include:

  • Bunions Pain and discomfort usually felt in the big toe caused by an aggravated joint. 
  • Arthritis Pain from arthritis developing in the bones of the foot and ankle due to altered alignment over the years.
  • Inflammation Pain caused by overuse of certain structures in the foot and lower leg. Reducing activity will usually improve symptoms. 
  • Plantar fasciitis Burning or stabbing pain felt in the heel and sole of the foot caused by inflammation of the plantar fascia comprising the underside of the foot. 
  • Shin pain Pain in the tibia or shin bone caused by decreased shock absorption qualities of flat feet upon impact with the ground. 
  • Ankle pain Pain experienced in the ankle. In severe cases, sprains or fractures can occur as a result of ankle pain. Ankle pain can be caused by high impact incidents, such as landing on uneven surfaces while running. 
  • Knee, hip, or lower back pain Pain in other areas of the body can arise from altered alignment of the lower leg during standing, walking, or running, which will increase the strain on these structures. 

Causes and Risk Factors of Flat Feet

Flat feet can be caused by a variety of factors. Babies are born with flat feet. As they grow, their arches develop. Flat feet can be inherited genetically from your parents or develop suddenly with age. Complications with health conditions such as diabetes and arthritis can lead to flat feet becoming worse as the disease progresses. 

  • Rheumatoid arthritis Leads to changes in bone structures caused by an autoimmune response, eventually leading to a loss of arch height. 
  • Overuse and strain Can cause the arches to drop over time.
  • Injury and fracture May lead to a sudden loss of arch height from injury to the bones, muscles, or ligaments required to maintain the arch of the foot. 
  • Complications with diabetes Leads to physical changes in the foot and a loss of arch height if left untreated. 
  • Ligament laxity Lax ligaments cannot provide support to the bones of the foot and lower leg, predisposing someone to developing flat feet. 
  • Pregnancy Ligament laxity is associated with pregnancy, which could lead to the development of flat feet. Pregnancy is also associated with weight gain, which is another possible cause of flat feet. 
  • Obesity Increased weight placed on the feet overtime may cause the arches to drop.

Conservative Treatments for Flat Feet

Flat feet can be managed well with conservative treatments such as exercise, therapy, and orthotics. In severe cases, surgery could be considered a necessary form of treatment. 

Exercises for flat feet aimed at strengthening the muscles of the foot will help provide support to the arch when weight is applied. Toe curls on a towel, stair heel raises, and stretching the sole of your foot will be helpful in treating flat feet. 

Orthotics designed for flat feet should provide your feet with the support they need to maintain alignment of the ankle and lower leg by keeping the arch elevated when under weight. Insoles or orthotics will decrease the symptoms that arise from physical activity or standing all day without adequate arch support. Insoles designed for flat feet or custom orthotics should provide the best relief of these symptoms. They’re a cost-effective way to manage your flat feet, and insoles can be used interchangeably between different pairs of shoes. 

A physical therapist will be able to assist you in managing your condition with advice on manual or hands-on therapy, prescription of strengthening and stretching exercises, and advice on orthotics.

Can Flat Feet Be Treated or Prevented Without Surgery?

Flat feet cannot be truly cured, but it can be managed well using a combination of the conservative methods mentioned above. The symptoms experienced from having flat feet can be alleviated using the correct orthotics and footwear. This can also prevent complications that may arise should the condition progress without treatment. If left untreated, hip and back pain can arise from misalignment starting in the feet. 

Should You See a Doctor for Flat Feet?

You should consult with a doctor if you experience:

  • Painful, numb, or stiff feet 
  • Sudden decrease in standing and walking balance
  • Loss of arch height in one foot 
  • Loss of arch height previously never having flat feet
  • Reduced ability to walk or stand on feet
  • Excessive bruising and swelling
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