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Can you fix flat feet? The short answer is yes you can! There are a number of treatment options, from wearing sensorimotor insoles, exercise, and even surgery. In the following article we will discuss all these options and more!
What are Flat Feet?
This is a condition medically known as "pes planus" and it describes feet with arches that are completely or partially collapsed. When the arch is entirely collapsed, the entire sole of the feet rests on the floor. That is, the full sole makes contact with the floor.
Why is this a bad thing? In the ideal or natural position of the feet, there is a slight elevation around the inward, mid-part of the feet. This is what we refer to as the arch and it should not be making contact with the floor. When it does, we know it as flat feet and the degree to which it touches the floor, determines the severity of the collapse.
Understanding Flat Feet
Everything we’ve just explained may still not paint a very clear picture so we will start by explaining how the feet work so we can understand the impact of the arch on the biomechanics of the foot.
The feet consist of about 26 bones, 33 joints, and more than 100 muscles along with tendons and ligaments. All of these work together as a finely-tuned machine, to deliver efficient support and biomechanics. In all of these, the arch is the key component.
The arch acts as a spring-like shock absorber, helping absorb impact stress and distributing weight of the body evenly. This ensures that the body's balance is maintained at all times, regardless of the activity.
Just for informational purposes, the arch has three main parts - the medial longitudinal arch, the lateral longitudinal arch, and the transverse arch. In flat feet, these arches are either collapsed or underdeveloped.
This can result in two types of flat feet - flexible flat feet or rigid flat feet.
Flexible Flat Feet
In this type of flat feet, the arch can be seen when the feet are not bearing any weight. That is, when the feet are up. However, once the foot is placed on the floor and bears the weight of the body, it collapses. This type of flat feet is the most common and thankfully, it usually does not show any of the symptoms associated with flat feet.
Rigid Flat Feet
This type of flat feet is visible whether the feet are bearing any weight or not. It's also this type that shows the most symptoms. Thankfully, it is not as common as the flexible type.
Between 20 to 30% of all adults have varying levels of flat feet. Having flat feet doesn’t automatically mean that you will have any issues. A lot of people may not experience any symptoms. That said, it may still be best to take some precautions to have proper arch support. We will elaborate on that later in the article.
What are the Symptoms of Flat Feet?
There are a number of symptoms that are associated with flat feet but the most common ones include the following:
· Pain in the Foot – The strain on the muscles and ligaments will often result in pain around the heel or arch. The pain may also affect other areas like the outer foot, inner ankle, and mid-foot. The pain will often get worse after prolonged periods of activity on your foot.
· Knee, Hip and Back Pain – One of the effects of flat feet is misalignment of the feet because of the absence of support from the arch. This misalignment disrupts the smooth operations of the leg's biomechanics which can result in compensatory movements that can increase stress to the hips and other parts, causing pain.
· Swelling - If you experience swelling around the inner part of your ankle, it can be a sign of posterior tibial tendon dysfunction. It could also be a sign that the surrounding tissues are irritated.
· Uneven Shoe Wear – As a result of the inward rolling of the feet (overpronation), the inner edge of the shoe’s sole will wear more than the outer edge.
Remember that in many cases, flat feet may be asymptomatic. That is, there won’t be any obvious symptoms like those listed above. You can however check to confirm if you have flat feet by carrying out the wet feet test. You can learn more about it in this article.
What Causes Flat Feet?
Flat feet can be passed down from parent to child and it can also be acquired over time. Aside from these two, it can also result from some health conditions, either from birth or over time. So, to help us understand these causes better, we will look at them based on whether it is congenital (from birth) or acquired over time.
Congenital Flat Feet
Babies naturally have flat feet because the arch is often not developed until around 6 to 8 years. However, for some, it remains undeveloped even after this, commonly resulting in flexible flat feet.
Here are some examples of causes linked to genetics and congenital factors:
· Parental input affects bone alignment, muscle tone, ligament laxity, and arch development. So, if both or even one parent has flat feet, the chances of their children having same is high. Health conditions that may have genetic basis can also increase the chances of a child having flat feet. These conditions include Ehlers-Danlos syndrome, and Marfan syndrome.
· Congenital factors that may not be hereditary will include conditions such as tarsal coalition, congenital vertical talus, amniotic band syndrome, idiopathic congenital flatfoot, and birth trauma.
Acquired Flat Feet
This category describes those who had their arches developed and then collapsed after some time. Factors that can cause this include the following:
· Aging – As with the general human body, the arch will begin to lose its elasticity as we grow older. This will eventually result in its collapse once the muscles, tendons, and ligaments completely lose their elasticity.
· Obesity – Since the feet carry the entire weight of the body when we stand, excessive weight will put undue pressure on the feet as a whole and the arch in particular. Over time, this weight can cause it to collapse.
· Injuries - Any injuries that result in the altering of the structure of the foot, can cause the arch to collapse.
· PTTD (Posterior Tibial Tendon Dysfunction - This tendon supports the arch so if it becomes weak or injured, the arch will lose its support, leading to its collapse.
· Pregnancy - The weight gain and hormonal changes associated with pregnancy can result in a temporary or even permanent collapse of the arch.
· Medical Conditions - Health conditions like diabetes, arthritis, and disorders like cerebral palsy can all lead to the arch falling.
· Lifestyle - Folks involved in high-impact activities can increase the likelihood of their arch falling. This risk is a lot higher when they carry out these activities without footwear that provides adequate support.
· Footwear - Generally, consistently wearing the wrong footwear (one that offers little or no support) can put a lot of strain on the arch causing it to eventually give in.
It is important to understand that people with hereditary or congenital flat feet, may not necessarily show any ill symptoms. What will eventually determine how much effect the condition has on them will be the other factors listed for “acquired” flat feet.
With the right support in place, they may never experience the usual symptoms associated with flat feet.
Fixing Flat Feet
It will be unforgivable to round off this article without discussing the treatments or management methods for flat feet. We shall look at this subject under two categories:
· Conservative Treatment
· Surgical Treatment or Intervention
Conservative Treatment to fixing flat feet
This approach includes all non-surgical approaches to the treatment and management of flat feet. These include the following:
The Use of Orthotic Devices
Orthotic devices like insoles can help simulate the missing arch support, performing functions such as weight distribution, shock absorption, and more. Depending on the severity of the symptoms, an over-the-counter or a custom-made orthotic can be used.
Stride Soles’ custom-made orthotics provide precise support for the medial longitudinal arch. This support makes up for the failings of the fallen arch. It also ensures the even distribution of weight so that the stress to the posterior tibial tendon is reduced.
Using a rigid TPU base, the inserts stabilize the foot, ensuring proper alignment. This prevents overpronation and thus improves posture and gait. The high-rebound foam core found in Stride Soles’ inserts provide amazing shock absorption and cushioning. This ensures better comfort and less fatigue from impact stress.
By offering orthotic inserts that are designed and custom-made to be a perfect fit, Stride Soles offers relief to people suffering from the symptoms of flat feet. Even those not suffering any symptoms can take advantage of these custom inserts to prevent injuries and any possible activation of these symptoms.
Exercise and Physical Therapy
These include exercises and routines designed to help strengthen both the foot and ankle muscles so they can give support to the arch. For example, when the posterior tibial tendon and intrinsic foot muscles are weak, the arch will collapse. Using targeted exercises, these muscles and tendons can be strengthened, building back the fallen arch.
In another example, when motion is limited as a result of tight Achilles tendons or calves, flat feet can get worse. To help fix this, stretching exercises can increase flexibility which will then enhance natural foot functions which will reduce the strain on the arches.
Regular exercise can generally strengthen the muscles, including the systems that support the arches, resulting in better flexibility and support. You will need a qualified physical therapist to determine the best therapy and exercise routines depending on the patient.
Supportive Footwear
Just as with orthotics, these are shoes that offer good arch support, keep the heels stabilized, and help the feet maintain general balance and stability.
Taping or Bracing
In cases of severe cases of flat feet or PTTD, ankle-foot orthoses can be used to provide a wrap that supports the foot, stabilizing the arch.
For relief from pain and inflammation, medication can be administered. This will often be together with another treatment since pain relief medication will not address the underlying condition.
For children, flat feet are usually not a problem since they are expected to develop as the child matures. However, treatment may be required if there is pain, rigidity, or if function is clearly inhibited.
Surgical Treatment to fixing flat feet
This treatment is reserved for when all conservative treatment options have been exhausted without any positive outcome. If the flatfoot continues to progress and remains severely painful, this may be the only option left.
Some examples of surgical interventions that may be required include:
· Tendon Repair or Transfer - This procedure repairs or reinforces the posterior tibial tendon (PTT). In the case of transfer, the FDL (Flexor Digitorum Longus) is transferred to provide assistance to the weakened PTT.
This procedure is best suited for cases where there is tendon dysfunction. It helps restore arch support, reducing pains as it stabilizes the foot. It also improves the alignment of the foot further enhancing balance and smooth foot function.
· Spring Ligament Repair - This repairs or recreates the spring ligament if it is stretched or completely torn. The procedure corrects the collapsed structure of the arch, improving its ability to efficiently provide shock absorption and weight distribution. Of course, it also reduces pain and improves stability.
· Calcaneal Osteotomy - a procedure to reposition the heel bone to ensure better alignment. When completed, proper foot alignment is achieved which will reduce overpronation, reducing the undue stress on the PTT and ligaments.
· Arthrodesis - This is a joint fusion procedure. Depending on the case, either 3 joints or a single joint will be fused. This procedure is performed to reduce joint motions that result in instability and pain. Such issues are often the result of compromised joint functions caused by severe flat feet or arthritis. By fusing the affected joints, the unwanted movement is reduced, and stability achieved. This provides relief from the pain caused by the unwanted movement.
These are just a few procedures that can be used for surgically treating flat feet. It's however important to note that most cases of flat feet do not require this level of intervention. The use of orthotic inserts is often enough to take care of the issue. Surgical interventions are considered only in extreme cases.
Conclusion
This has been an extensive look at flat feet in our attempt at answering the question – can you fix flat feet? The information in this article was designed to provide you with all the information you need to understand exactly what flat feet or foot is and how it can be managed.
You now also know that Stride Soles offers the most affordable custom-made orthotic inserts that can provide the relief that many people with flat feet are searching for. You can start the process of ordering your very own Stride Soles custom-made orthotic inserts right now.
