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Flat foot: causes, symptoms and treatments

by Alex Hales

The flat foot is a pathology that develops during growth in children. What are the causes and symptoms? Our Howard County Foot & Ankle share their advice on the most appropriate treatments to reduce pain.

What is a flat foot?

The flat foot has several origins: congenital, neurological, rheumatic and traumatic. It is characterized by the collapse of the arch of the foot which is then in contact with the ground completely or almost completely. The heel is in valgus (heel thrown outwards) and the forefoot is well flattened on the ground. It is generally favored by overweight and poor footwear. There are several types of flat feet related to the age of people:

In children: it is normal for children to be born with flat feet. In 65% of cases, the foot evolves spontaneously towards complete correction between 5 and 6 years and 30% remain flat but asymptomatic. Of the 5% who remained very flat, 2% will have no functional problem but 3% will require therapeutic care. This flat foot may be due to an abnormal joining of the bones, called synostosis or synchondrosis.

In adolescents: under the effect of weight gain, longer walks, and sporting activity, the initially asymptomatic flat foot can become painful.

In adults: it is a persistence of the flat foot of the child or it is linked to an infectious, inflammatory, neurological, traumatic disease. It could also develop during pregnancy, obesity, or prolonged bed rest. The symptomatology is variable.

Flatfoot is classified into three stages:

Stage 1: widening of the imprint at the level of the center of the foot.

Stage 2: entire plantar surface on the ground.

Stage 3: internal sagging.

flat foot stages

What are the symptoms of a flat foot?

The symptoms are multiple and variable depending on the stage. It can be painless in childhood, and then become painful as it grows. In adults, the pain is not constant and can appear as a result of venous disorders, overwork or intercurrent pathology. In addition, this pain can occur or be amplified when standing and walking, especially in people who are overweight or have a problem with their gait.

Besides pain, here is a list of other existing symptoms:

Support on the big toe is impossible.

Consequent postural imbalance

Deviation of the foot outward and the heel inward

Irregularities, fatigue, limping or unsightly (duck) gait.

Development of deformities in the foot such as hallux valgus or calluses.

Ankle problems: joint pain.

Plantar fasciitis: inflammation of the fibrous envelope of the heel.

Pain in the knees, lower back (lumbar).

As a result, abnormal wear is regularly found on the internal and anterior edges of the sole of the shoes.

What are the main causes?

In 90-97% of cases, the pathology develops due to lack of treatment during growth. There is not just one cause for the appearance of flat feet. Rather, it is a combination of several factors.

Child, the flat foot is rather of congenital origin. The causes of appearance are then oriented towards:

a family predisposition.

Excessive weight: the arch sags because it cannot support the weight of the child.

Ligaments that are too short or too elastic.

Muscle deficit or hypotonic.

An imbalance between the back and the front of the foot.

In adults, the flat foot is generally already present and manifests itself or intensifies according to several elements:

Unstable ankles: during internal and external rotation of the foot (pronation)

Leg muscle dysfunction

Unequal lower limbs: a leg shorter than the other

A degenerative disease

Inflammation of the joints of the bones of the foot: osteoarthritis rheumatoid arthritis

aging: with age, muscle strength weakens. The rear foot goes into the valgus (the foot tends to lean outwards) and causes the central part of the plantar sole to collapse. We also notice a spreading of the metatarsal pallet.

The practice of physical activity: the foot is enormously stressed which tires the arch of the foot, especially if the shoes are not adapted.

trauma: following a fracture or tearing of the ligaments of the foot. The bones of the foot can end up badly positioned with respect to each other.

What are the treatments to avoid the effects of flat feet?

Before 4 years, no treatment is justified because it is normal to be born with flat feet. The correction occurs naturally with growth. Beyond that, several solutions are possible to reduce pain and regain stable walking:

Orthopedic insoles:

The purpose of orthopedic insoles is to correct the position of the foot.

This will prevent or relieve pain, as well as rebalancing the posture. In children, a so-called “stimulation”

An insole is made which will activate the muscle chains of the foot and leg so that the arch of the foot is formed and the foot grows in the right axis. Thanks to the insoles, the knees and hips will maintain a good posture and remain in “line” thus preserving the joints

In adolescents who are fragile at the level of the joints, stimulation remains with arch support if the foot is already very sagging. The prevention of injuries and postural pain is very important so as not to interfere with his daily activities.

Thereafter, they worked with elements in order to meet the needs and the necessary corrections. Then they are tried on directly in the patient’s shoes. This ensures that the locations of the relief elements are well placed and relieve the pain caused by flat feet. Checking the patient’s comfort with new insoles is essential for their effectiveness.

For more information on suitable treatments for flat feet, do not hesitate to contact Howard County Foot & Ankle Specialists.

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