Flat Feet (Pes Planus) or Fallen Arches This is a problem with the entire bottom of the foot coming into complete or near complete contact with the ground. In some people (almost 30% of our population), the arch just never develops in one or both feet. In infants, the misleading appearance of flat feet is common partly due to “baby fat” ; which hides the developing arch ; and partly because the arch has not fully developed. The human arch develops through early childhood as the muscles and connective tissues grow and strengthen the arch. It is really a truss and joist system where the bones in the foot form the roof tissues and the connective tissue and muscles form the “joists” that hold the bottom together. Sort of like a triangular roof and a line across the bottom that holds it together (see picture A). There are many types of problems that can occur in the foot but we are talking about flat feet today. If you have flat feet there are many causes. žFamily History – Flat feet can run in the family žInjury žArthritis žObesity – Too much weight/pressure flattens arches žRuptured Tendon of the Tibialis Posterior, attaches to inner arch and ankle. žNervous System or Muscle Diseases žTarsal Coalition – Fusing of bones in the foot žDiabetic or Other Peripheral Neuropathy žAge and Wear/Tear – years of using your feet! If you have flat feet it can cause problems. The symptoms may vary and generally depend on the severity of your condition, your weight and type of support you provide for your feet. The problem is your arch collapses each time you step on it, which creates too much motion in the foot, leading to pain and tenderness. The most common complaints of people with flat feet include: žPain or swelling on the inside part of the ankle žPain or aching in the foot in general žPain in the arch of the foot žPain or cramping in the calf muscle žPain in the inside part of the knee žPain or tightness in the hips and low back žStiffness in the feet žShoes wear unevenly To treat this problem there are several approaches we can try. The first is to examine the feet and determine the cause of the problem. We do a painless nerve test which can help, plus we measure how many degrees of motion there are in the foot and ankle. This gives us a good idea of the true ‘pattern’ of your problem and most importantly points to possible solutions for each case. We can try to strengthen certain muscles in the foot or ankle to help build your arches back up again. We can use ultrasound with cortisone cream on the skin to reduce swelling and inflammation. We can discuss ways to correct the biomechanics using either inserts (over the counter arch supports), custom orthotics which are custom made from a mold of your foot or braces if your problem is severe. We may also find that because your arches have collapsed that the inside of your foot drops down and your toes point out. Many of these patients develop pain on the inner knee as the foot drops down; they also get tight hip and low back pain due to the muscles which rotate the hips out, getting too tight. We can help treat these problems with therapy, strengthening, and stretching. Correct foot wear is very much part of the solution as well. We can advise you on the correct foot wear for your type of feet. We will soon be carrying Drew Shoes. This is an orthopedic line of shoes which is a little deeper to accommodate your foot plus an insert or orthotic (arch support). They are actually quite fashionable and can be ordered to any size for men or women, including dress and casual shoes. Correcting foot and ankle problems involves careful examination and analysis of your problem. At TriState Hand and Occupational Therapy you can get your problem handled instead of being in pain. Call us at (301) 759-4263 for a free screening or ask your nurse practitioner, doctor, or physician assistant for an order. Get walking, shopping, doing things you love, and get back on your feet. Isn’t it time you got your problem handled? Give us a call! |
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