A person with flat feet (fallen arches) has low arches or no arches at all. Most cases don't cause problems and treatment isn't usually needed. The arch, or instep, is the inside part of the foot that's usually raised off the ground when you stand, while the rest of the foot remains flat on the ground. Most people have a noticeable space on the inner part of their foot (the arch). The height of the arch varies from person to person.
A Rigid Flat Foot may be congenital, where the arch never develops when growing. A Rigid Flat Foot can also be acquired due to disease processes involving inflammatory arthritis, neurological conditions such as Charcot neuro-arthropathy or trauma. A Flexible Flat Foot (fallen arches) may also be congenital where excessive pronation occurs for shock absorption. In some cases this condition may be the result of neurological disease or injury involving muscle weakness, hyper-mobile joints or ligament laxity. These conditions may allow for excessive pronation causing the arch to fall when weight bearing or during activity. Both of these foot types can result in posture mal-alignment involving the lower back, hips, knees and feet which may result in pain in those areas.
Having flat feet can be painless and is actually normal in some people. But others with flat feet experience pain in the heel or arch area, difficulty standing on tiptoe, or have swelling along the inside of the ankle. They may also experience pain after standing for long periods of time or playing sports. Some back problems can also be attributed to flat feet.
If you notice that your feet are flat, but you?re not really experiencing any pain, then you?re probably okay to go without a visit to the podiatrist (unless, of course, you have a lack of feeling in your foot). You can schedule a hair appointment instead, or maybe see a movie. However, once painful symptoms start to appear, it?s better to skip the hirsute (or cinematic) experience and go see your foot doctor. Your podiatrist will likely make the diagnosis by examining your foot visually, asking about symptoms you may be experiencing, and may test your muscle strength. You may be asked to stand on your toes (in a ballerina pose, if you prefer, although that?s certainly not required), or walk around the examining room, and you may need to show the podiatrist your shoes. He or she may comment on your excellent taste in footwear, but is more likely to check your shoes for signs of wear that may indicate fallen arches. Your podiatrist may recommend X-rays, a CT scan or an MRI in order to get a look at the interior of your foot, although the best diagnosis usually comes from the doctor?s own in-person examination.
Non Surgical Treatment
The treatment your podiatrist recommends will depend upon the trouble and pain you?re experiencing. Custom shoe inserts (orthotics) are most often recommended and are quite effective. Stretching exercises to loosen and strengthen the supporting tendons may also be recommended. Orthotic devices or bracing. To give your arch the support it needs, your foot and ankle surgeon may recommend an ankle brace or a custom orthotic device that fits into your shoe to support the arch. A short-leg cast or boot may be worn to immobilize the foot and allow the tendon to heal. Ultrasound therapy and stretching exercises may help rehabilitate the tendon and muscle following immobilization. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, help reduce the pain and inflammation. Your foot and ankle surgeon may recommend changes in your footwear.
In cases of flat feet that have progressed substantially or have failed to improve with non-surgical treatment, surgery may be required and in some advanced cases, surgery may be the only option. Your foot and ankle surgeon will determine the best approach for you.
Patients may go home the day of surgery or they may require an overnight hospital stay. The leg will be placed in a splint or cast and should be kept elevated for the first two weeks. At that point, sutures are removed. A new cast or a removable boot is then placed. It is important that patients do not put any weight on the corrected foot for six to eight weeks following the operation. Patients may begin bearing weight at eight weeks and usually progress to full weightbearing by 10 to 12 weeks. For some patients, weightbearing requires additional time. After 12 weeks, patients commonly can transition to wearing a shoe. Inserts and ankle braces are often used. Physical therapy may be recommended. There are complications that relate to surgery in general. These include the risks associated with anesthesia, infection, damage to nerves and blood vessels, and bleeding or blood clots. Complications following flatfoot surgery may include wound breakdown or nonunion (incomplete healing of the bones). These complications often can be prevented with proper wound care and rehabilitation. Occasionally, patients may notice some discomfort due to prominent hardware. Removal of hardware can be done at a later time if this is an issue. The overall complication rates for flatfoot surgery are low.