What really is Flat Feet or Pes Planus?
A flat foot is also known as Pes Planus which in simple terms, is a fallen arch of the foot that causes the whole foot to make contact with the ground. The arch on the inside of the foot can be high in some and low in others and if this does fall to the ground and makes contact with the floor we call this a flat foot or Pes Planus. The word ‘Pes’ stands for “human foot” and the word ‘planus’ stands for “flat”, and in specific terms, it is the loss of the medial longitudinal arch of the foot, heel, a valgus deformity, and medial talar prominence.
Children have a low and flat arch and their arch normally develops between the ages of 9-10yrs. It is common for children to have flat feet and is not of any concern. Many will grow into adults and still have a low arch and their function and development are not affected and are symptom and pain-free. Remember this is a normal variation of foot type. Sometimes flat feet can put a lot of strain on your ligaments, muscles, and joints but this is not all people and there can also be other factors and causes for this not just the flat foot.
What causes Pes Planus?
A flat foot can be caused by many factors such as hypermobility, Tarsal coalition, Tibial Posterior dysfunction and others.
Hypermobility is when our joints have increased movement and there is more laxity of our ligaments. This can be present and be seen in many joints of the body and with a flat foot.
Tendon weakness or Tibialis posterior Tendon dysfunction. This is a large tendon that is situated on the inside of the ankle and helps lift the arch upward providing much support. It can degenerate causing it to stretch and not work correctly. Adults can develop a lowering of their arch due to injuring the Tibialis Posterior Tendon. This is known as ‘adult acquired flat foot and may only affect one foot at a time.
Increased weight can cause more strain on the muscles, tendons and ligaments that support the arch leading to pain. This means that the muscles have to work harder to support the foot and arch during standing and gait. Many times it's not the increased weight that is the issue but the muscular weakness and deconditioning that is unable to provide adequate support.
What Treatments can I do to help my flat foot?
If flat feet are causing problems such as pain or issues with walking or doing activity/sport, you may need treatment. It is advisable to be seen by a specialist like a physiotherapist or a podiatrist and they can help at the initial stages of intervention. They can guide you on the correct treatment and if you require further intervention such as Imaging or an orthopaedic review.
A foot specialist can give assistance in :
Rehabilitation and exercises to help increase the strength of the muscles that help support the arch. There are many power muscles and stabilisers and they all have to be exercised very specifically. Thus correct exercise intervention can significantly help this.
Footwear. These should be guided by your foot type and lifestyle.
Shoe insoles ( Orthotics) to support your feet. These can be off the shelf orthotics, however, you can have custom made orthotics made by a podiatrist.
If you get no resolution then a discussion with an orthopaedic consultant can be taken.
We would advise that you are seen in the clinic for an assessment to determine your causative factors and the most suitable treatment. We can help guide you through your treatment and process to help you recover. If you require further assistance we can then direct you to the appropriate podiatrists or orthopaedic consultants if required.