Working With Fallen Arches

Overview

Flat Feet

Flat feet can develop as an adult ("adult acquired flatfoot") due to injury, illness, unusual or prolonged stress to the foot, faulty biomechanics,[5] or as part of the normal aging process. Flat feet can also occur in pregnant women as a result of temporary changes, due to increased elastin (elasticity) during pregnancy. However, if developed by adulthood, flat feet generally remain flat permanently.




Causes

Fallen arches may be caused by a number of causes, including increased elastin during pregnancy, arthritis, injury, excessive stress on the foot, fused bones in the foot, or an extra bone. They may cause not only foot pain, but also pain in the legs, knees, and back and a loss of mobility. The condition is most often treated with orthotics, structures placed in the shoes to support the feet, but this may not be enough for severe cases. Exercises to strengthen and rebuild the arches can also be helpful. Surgery is sometimes the best method of treatment, as it can completely rebuild the arches and has lasting results, but it is quite expensive and considered a last resort.




Symptoms

Flat feet don't usually cause problems, but they can put a strain on your muscles and ligaments (ligaments link two bones together at a joint). This may cause pain in your legs when you walk. If you have flat feet, you may experience pain in any of the following areas, the inside of your ankle, the arch of your foot, the outer side of your foot, the calf, the knee, hip or back. Some people with flat feet find that their weight is distributed unevenly, particularly if their foot rolls inwards too much (overpronates). If your foot overpronates, your shoes are likely to wear out quickly. Overpronation can also damage your ankle joint and Achilles tendon (the large tendon at the back of your ankle).




Diagnosis

Many medical professionals can diagnose a flat foot by examining the patient standing or just looking at them. On going up onto tip toe the deformity will correct when this is a flexible flat foot in a child with lax joints. Such correction is not seen in the adult with a rigid flat foot. An easy and traditional home diagnosis is the "wet footprint" test, performed by wetting the feet in water and then standing on a smooth, level surface such as smooth concrete or thin cardboard or heavy paper. Usually, the more the sole of the foot that makes contact (leaves a footprint), the flatter the foot. In more extreme cases, known as a kinked flatfoot, the entire inner edge of the footprint may actually bulge outward, where in a normal to high arch this part of the sole of the foot does not make contact with the ground at all.




Non Surgical Treatment

What we want to do is support the arch and maintain it in that curved position. So what you want is to bring the foot into a position where you hold and support the arch so you can get that correct heel-midfoot-big toe contact. You would achieve that with a level of arch support. People will take different levels of support, if you?re somebody who has movement in your arch, a strong level of support will hold and maintain you whereas if you?re someone whose arch has collapsed it could need more support and a level of correction built into the support to realign you. If you think of it, when your arch drops, it affects your foot but it also has a biomechanical effect on the rest of the body. But nothing that can?t be solved.




Surgical Treatment

Adult Acquired Flat Feet

Surgery for flat feet is separated into three kinds: soft tissue procedures, bone cuts, and bone fusions. Depending on the severity of the flat foot, a person?s age, and whether or not the foot is stiff determines just how the foot can be fixed. In most cases a combination of procedures are performed. With flexible flat feet, surgery is geared at maintaining the motion of the foot and recreating the arch. Commonly this may involve tendon repairs along the inside of the foot to reinforce the main tendon that lifts the arch. When the bone collapse is significant, bone procedures are included to physically rebuild the arch, and realign the heel. The presence of bunions with flat feet is often contributing to the collapse and in most situations requires correction. With rigid flat feet, surgery is focused on restoring the shape of the foot through procedures that eliminate motion. In this case, motion does not exist pre-operatively, so realigning the foot is of utmost importance. The exception, are rigid flat feet due to tarsal coalition (fused segment of bone) in the back of the foot where freeing the blockage can restore function.