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Flat Feet

Flat Feet: Causes, Symptoms, Diagnosis, Treatment, and Prevention

The condition flat feet, also known as pes planus, occurs when the arch is low or absent on the foot, which distributes body weight and absorbs shock. When people with flat feet stand or walk, their arches may not be visible, or they may only show when they raise their foot off the ground.

In general, flat feet do not cause problems, but some people may experience pain, stiffness, swelling, or difficulty walking or running. Flat feet can also affect the alignment of the legs and the posture of the body, causing problems in the ankles, knees, hips, or back.

Causes of Flat Feet

Flat feet can be caused by various factors, such as:

  • Genetics: Some people are born with flat feet or develop them during childhood since their arches don't form properly. This is referred to as congenital or flexible flat feet. It is the most common type of flat feet and usually does not require any treatment unless it causes pain or other problems.

  • A person's arches may gradually flatten as he or she ages due to wear and tear on the ligaments and tendons that support the arch. This is referred to as adult-acquired or fallen arches. People with diabetes, arthritis, high blood pressure, or foot injuries or surgeries are more likely to have it.

  • Trauma or illness: A fracture, sprain, or inflammation can damage the foot's arch structure and lead it to collapse. Flat feet can also result from medical conditions such as rheumatoid arthritis, cerebral palsy, or muscular dystrophy that affect the muscles and nerves that control the feet.

  • Having flat feet can be caused by wearing shoes that don't fit well, have poor arch support, or are too tight or loose. Standing or walking for long periods of time, especially on hard or uneven surfaces, can also stress the foot and flatten the arch.

Symptoms of Flat Feet

Many people with flat feet do not have any symptoms and can function normally. However, some people may experience one or more of the following symptoms:

  • Pain or discomfort in the foot, ankle, heel, arch, calf, knee, hip, or back, especially after prolonged standing, walking, or running

  • Swelling, redness, or warmth along the inner side of the foot or ankle

  • Difficulty in moving the foot, such as pointing the toes up or down or turning the foot inward or outward

  • Difficulty in fitting into shoes or finding shoes that are comfortable

  • Changes in the shape or appearance of the foot, such as a flattened or widened foot, a bulging or sagging arch, or toes that point outward

  • Changes in the way of walking or running, such as a flat-footed gait, limping, or overpronation (rolling the foot inward excessively)

Diagnosis of Flat Feet

In order to diagnose flat feet, a doctor usually performs a physical exam and asks about the person's medical history, symptoms, and activities. It may also be necessary for the doctor to observe the feet, ankles, and legs as they move, walk, and run on a flat surface or on a treadmill.

The doctor may also order one or more of the following tests to confirm the diagnosis and rule out any underlying conditions or complications:

  • X-rays: These are images that show the bones and joints of the foot and ankle and can reveal any abnormalities, fractures, or arthritis.

  • Ultrasound: This is a test that uses sound waves to create images of the soft tissues of the foot and ankle and can detect any tears, inflammation, or swelling of the ligaments, tendons, or muscles.

  • MRI: This is a test that uses magnetic fields and radio waves to create detailed images of the structures of the foot and ankle and can show any damage, inflammation, or infection of the bones, cartilage, ligaments, tendons, or nerves.

  • CT scan: This is a test that uses X-rays and a computer to create cross-sectional images of the foot and ankle and can show any abnormalities, fractures, or tumors of the bones or soft tissues.

Treatment of Flat Feet

The treatment of flat feet depends on the cause, severity, and symptoms of the condition. The main goals of treatment are to relieve pain, improve function, and prevent further damage or complications.

The treatment options may include one or more of the following:

  • Rest: This involves avoiding or limiting activities that cause pain or stress on the foot, such as standing, walking, or running for long periods of time, or wearing high heels or tight shoes. Resting the foot can help to reduce inflammation and promote healing.

  • Ice: This involves applying ice packs or cold compresses to the affected area for 15 to 20 minutes several times a day, especially after activity. Ice can help to numb the pain and reduce swelling and inflammation.

  • It involves the use of over-the-counter or prescription medications to alleviate pain and inflammation, such as nonsteroidal anti-inflammatory drugs (NSAIDs), acetaminophen, or corticosteroids. It is important to use these drugs with caution and under the guidance of a doctor due to their potential side effects.

  • Orthotics: These are devices that are inserted into shoes to provide support, cushioning, and stability for the foot and arch. Orthotics are a type of footwear that helps to correct the alignment of the foot and ankle, distribute body weight evenly, and reduce foot stress. They can be custom-made or purchased over-the-counter, depending on the person's needs and preferences.

  • Providing support, protection, and immobilization to the foot and arch is the purpose of braces and splints, which are worn around the foot and ankle. In addition to preventing further injury, they can also reduce pain and inflammation, and improve foot function. Depending on the condition and the doctor's recommendation, braces or splints may be worn day or night.

  • In physical therapy, muscles, tendons, and ligaments of the foot and ankle are strengthened, and range of motion and flexibility are improved. The goal of physical therapy is to reduce pain and inflammation and promote blood flow and healing by using massage, ultrasound, electrical stimulation, and other modalities.

  • In cases of severe or complicated conditions or when other treatments fail to provide relief, surgery is the last resort option. Foot and ankle structures, such as ligaments, tendons, bones, or joints, can be repaired or rebuilt through surgery. It is possible to restore function and appearance to the foot and arch with surgery, and to prevent further complications and damage. Surgery, however, has risks and complications, such as infection, bleeding, nerve damage, or failure of the procedure, as well as a long recovery period.

Prevention of Flat Feet

Flat feet can be prevented or delayed by taking the following steps:

  • Maintain a healthy weight: If you are overweight or obese, you put extra pressure and stress on your feet and arches, which increases your chances of flat feet. It is possible to prevent or delay the development of flat feet by losing weight or maintaining a healthy weight.

  • Wear proper footwear: Wearing shoes that fit well, have good arch support, are comfortable, and are appropriate for the activity can help protect and support the feet and arches, and prevent or reduce foot stress. Flat feet can be caused or worsen if you wear shoes that are too tight, too loose, too high, or too flat.

  • Taking frequent breaks and resting the feet can help you avoid or worsen flat feet. Standing, walking, or running for a long time, especially on hard or uneven surfaces, can cause or worsen flat feet. If possible, choose activities that are low-impact, such as swimming, cycling, or yoga, which can help to keep the feet and arches healthy and flexible, without causing excessive stress on the foot.

  • Do exercises and stretches for the foot and arch: Strengthening the muscles, tendons, and ligaments of the foot and ankle, and improving the range of motion and flexibility of the foot and arch, can be achieved by doing exercises and stretches for the foot and arch. The following exercises and stretches can be used for the foot and arch:

    • Toe raises: Stand with your feet flat on the floor, and slowly lift your toes off the ground, keeping your heels on the floor. Hold for a few seconds, and then lower your toes back to the floor. Repeat 10 to 15 times.

    • Heel raises: Stand with your feet flat on the floor, and slowly lift your heels off the ground, keeping your toes on the floor. Hold for a few seconds, and then lower your heels back to the floor. Repeat 10 to 15 times.

    • Arch lifts: Stand with your feet flat on the floor, and slowly lift your arches off the ground, keeping your toes and heels on the floor. Hold for a few seconds, and then lower your arches back to the floor. Repeat 10 to 15 times.

    • Towel curls: Sit on a chair with your feet flat on the floor, and place a towel under your toes. Curl your toes to scrunch the towel, and then straighten your toes to release the towel. Repeat 10 to 15 times.

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