Flat Feet
Flat feet (also called pes planus or fallen arches) is a postural deformity in which the arches of the foot collapse, with the entire sole of the foot coming into complete or near-complete contact with the ground. Some individuals (an estimated 20–30% of the general population) have an arch that simply never develops in one foot (unilaterally) or both feet (bilaterally).
There is a functional relationship between the structure of the arch of the foot and the biomechanics of the lower leg. The arch provides an elastic, springy connection between the forefoot and the hind foot. This association safeguards so that a majority of the forces incurred during weight bearing of the foot can be dissipated before the force reaches the long bones of the leg and thigh.
Flat feet can develop in adulthood (“adult acquired flatfoot”) due to injury, illness, unusual or prolonged stress to the foot, faulty biomechanics, or as part of the normal aging process. This is most common in women over 40 years of age. Known risk factors include obesity, hypertension and diabetes. 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.
Children and adolescents with flat feet are a common occurrence. The human arch develops in infancy and early childhood as part of normal muscle, tendon, ligament and bone growth. Flat arches in children usually become high arches as the child progresses through adolescence and into adulthood. Since children are unlikely to suspect or identify flat feet on their own, it is important for adult caregivers to check on this themselves. Besides visual inspection, caregivers should notice when a child’s gait is abnormal. Children who complain about calf muscle pains, arch pain, or any other pains around the foot area may be developing or have developed flat feet. Children with flat feet are at a higher risk of developing knee, hip, and back pain.
The effects of flat feet fall under two categories, which are asymptotic and symptomatic. Individuals with rigid flat feet tend to exhibit symptoms such as foot and knee tendinitis.
A person with flat feet tends to overpronate in the running form and other persons with flat feet may have an underpronating if they are not a neutral gait. A person who overpronates in his or her running form may be more susceptible to shin splints, back problems, and tendonitis in the knee. Running in shoes with extra medial support or using special shoe inserts, orthotics, may help correct one’s running form by reducing pronation and will reduce risk of injury.
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 adults 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. You can use this Children’s foot analysis tool to test your child’s feet and determine if your child needs assistance with their feet. 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.
On plain radiography, flat feet can be diagnosed and graded by several measures, the most important being the talonavicular coverage angle, the calcaneal pitch, and the talar-1st metatarsal angle (Meary’s angle). The talonavicular coverage angle is abnormally laterally rotated in flat feet. It is normally up to 7 degrees laterally rotated, so a greater rotation indicates flat feet.
Pathophysiology
Dysfunction of the foot can often arise from the foot losing its normal structural support, thus altering is shape. An imbalance in the forces that tend to flatten the arch and those that support the arch can lead to loss of the medial longitudinal arch. An increase in the arch-flattening effects of the triceps surae or an increase in the weight of the body will tend to flatten the arch. Weakness of the muscular, ligamentous, or bony arch supporting structures will lead to collapse of the arch. The main factors that contribute to an acquired flat foot deformity are excessive tension in the triceps surae, obesity, PTT dysfunction, or ligamentous laxity in the spring ligament, plantar fascia, or other supporting plantar ligaments. Too little support for the arch or too much arch flattening effect will lead to collapse of the arch. Acquired flat foot most often arises from a combination of too much force flattening the arch in the face of too little support for the arch. Treatment of the adult acquired flat foot is often difficult. The clinician should remember the biomechanics of the normal arch and respond with a treatment that strengthens the supporting structures of the arch or weakens the arch-flattening effects on the arch. After osteotomies or certain hindfoot fusions, the role of the supporting muscles of the arch, in particular the PTT, play less of a role in supporting the arch. Rebalancing the forces that act on the arch can improve function and lessen the chance for further or subsequent development of deformity.
Research has shown that tendon specimens from people who suffer from adult acquired flat feet show evidence of increased activity of proteolytic enzymes. These enzymes can break down the constituents of the involved tendons and cause the foot arch to fall. In the future, these enzymes may become targets for new drug therapies
OPTION ONE
A 2ft custom made Orthotic puts an end to your foot pain caused by this painful condition. Conservative care is highly successful in the cavus high arch foot. An orthotic with a high lateral heel flange, a valgus post and a sub-first metatarsal cutout can balance the foot. Often, the first ray is plantarflexed and a cutout of the first metatarsal head is essential for forefoot balancing. In severe ankle instability cases, an over the counter ankle-foot orthotic or a custom ankle-foot orthotic can be beneficial in balancing the foot and ankle. Consideration of a first ray cutout should also be part of the bracing process.
Our promise is; no drugs, no pricey consultation fees, no more pain and it’s backed by the 2ft 100% Comfort Guarantee.
Your custom made 2ft Orthotic supports all three of your foot arches not just one. It is designed to realign the ankle joint so the centers of gravity correctly transfer the compression forces of your body down to the ground correctly. This ensures that your standing stance and walking gait normalize and work as designed. The inbuilt torsion & compression bars take the strain off of the Plantar Fascia and assist in putting a spring back intro your every step making it easier to walk and run. Our Orthotic is a marvel of engineering and it can significantly change your life. Try it on and you will never look back.
OPTION TWO
TEMPORARY RELIEF
Medication; over the counter medications such as pain killers, or anti inflammatory drugs are often suggested for temporary relief of pain symptoms. Often suggested medications include; Acetaminophen (Tylenol, others), ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve) can help you control the pain of a bunion. Cortisone injections are also a go to for temporary relief.
Applying ice. Icing your bunion after you’ve been on your feet too long or if it becomes inflamed can help relieve soreness and inflammation.
Changing shoes. Wear roomy, comfortable shoes that provide plenty of space for your toes.
OPTION THREE
Surgical Procedures
There are several possible procedures to forcefully rectify flatfeet in children and adults. This type (hyprocure Surgery) in the image to the right of your screen involves screwing a bolt between several of the foots bones just below the ankle.
- Fusing foot or ankle bones together (arthrodesis)
- Cutting or changing the shape of the bone (osteotomy)
- Cleaning the tendons’ protective coverings (synovectomy)
- Adding tendon from other parts of your body to tendons in your foot to help balance the “pull” of the tendons and form an arch (tendon transfer)
- Grafting bone to your foot to make the arch rise more naturally (lateral column lengthening)
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