Babies are often born with flat feet, which may persist well into their childhood. This occurs because children?s bones and joints are flexible, causing their feet to flatten when they stand. Young babies also have a fat pad on the inner border of their feet that hides the arch. You still can see the arch if you lift your baby up on the tips of the toes, but it disappears when he?s standing normally. The foot may also turn out, increasing the weight on the inner side and making it appear even more flat.
As children grow, their legs will experience developmental changes that can result in excess flattening of the arches with weight bearing. One example is genu valgum, or knock-knees, a usually normal, temporary condition in children at different stages of growth. A tight calf muscle or Achilles tendon can also contribute to a flat foot. Many children will experience tight calf muscles as they go through growth spurts. Conditions that are present at birth and are often diagnosed early include: metatarsus adductus, calcaneovalgus and congenital vertical talus. Tarsal coalitions are congenitally fused foot bones that cause a rigid flat foot often associated with painful muscle spasms. This type of flat foot is usually diagnosed later in childhood or in adulthood. Any condition that causes loose ligaments can result in a flat foot or lower-than-normal arch. Ligaments are bands of tissue that connect bones to each other and have an important role in giving form to foot arches. An example of a condition that causes loosening of ligaments is pregnancy, where normal hormonal changes relax the ligaments. Diseases that cause loose ligaments include Ehlers-Danlos syndrome, Marfan's syndrome and rheumatoid arthritis. If one leg is longer than the other, one foot may be flat in relation to the other to compensate. Usually the foot on the longer limb will have a flatter arch in an effort to shorten that limb, balancing-out the unevenness. Leg length inequality can be caused by spinal abnormalities such as scoliosis. It can also be due to an actual difference in length of one leg bone compared to the other.
The primary symptom of fallen arches is painful or achy feet in the area in which the foot arches or on the heel. This area may become swollen and painful to stand still on. This causes the patient to improperly balance on their feet which in turn will cause other biomechanical injuries such as back, leg and knee pain.
Flat feet are easy to identify while standing or walking. When someone with flat feet stands, their inner foot or arch flattens and their foot may roll over to the inner side. This is known as overpronation. To see whether your foot overpronates, stand on tiptoes or push your big toe back as far as possible. If the arch of your foot doesn't appear, your foot is likely to overpronate when you walk or run. It can be difficult to tell whether a child has flat feet because their arches may not fully develop until they're 10 years of age.
arch support plantar fasciitis
Non Surgical Treatment
Some patients with flat feet may automatically align their limbs in such a way that unpleasant symptoms never develop. In such cases treatment is not usually required. Pain in the foot that is caused by flat feet may be alleviated if the patient wears supportive well-fitted shoes. Some patients say that symptoms improve with extra-wide fitting shoes. Fitted insoles or orthotics (custom-designed arch supports) may relieve pressure from the arch and reduce pain if the patient's feet roll or over-pronate. The benefits of an orthotic only exist while it is being worn. Patients with tendonitis of the posterior tibial tendon may benefit if a wedge is inserted along the inside edge of the orthotic - this takes some of the load off the tendon tissue. Wearing an ankle brace may help patients with posterior tibial tendinitis, until the inflammation comes down. Rest, doctors may advise some patients to rest and avoid activities which may make the foot (feet) feel worse, until the foot (feet) feels better. A combination of an insole and some kind of painkiller may help patients with a ruptured tendon, as well as those with arthritis. Patients with a ruptured tendon or arthritis who find insoles with painkillers ineffective may require surgical intervention. Patients, usually children, whose bones did not or are not developing properly, resulting in flat feet from birth, may require surgical intervention to separate fused bones (rare). Bodyweight management, if the patient is obese the doctor may advise him/her to lose weight. A significant number of obese patients with flat feet who successfully lose weight experience considerable improvement of symptoms.
Feet that do not respond to the treatments above may need surgery. The surgery will help to create a supportive arch.
Time off work depends on the type of work as well as the surgical procedures performed. . A patient will be required to be non-weight bearing in a cast or splint and use crutches for four to twelve weeks. Usually a patient can return to work in one to two weeks if they are able to work while seated. If a person's job requires standing and walking, return to work may take several weeks. Complete recovery may take six months to a full year. Complications can occur as with all surgeries, but are minimized by strictly following your surgeon's post-operative instructions. The main complications include infection, bone that is slow to heal or does not heal, progression or reoccurrence of deformity, a stiff foot, and the need for further surgery. Many of the above complications can be avoided by only putting weight on the operative foot when allowed by your surgeon.