Flat feet (pes planus) refers to a condition whereby the feet arches collapse and are in total or partial touch with the floor. It is also referred to as pes planus, pes valgus, fallen arches or pronated feet.
The arches on the feet are flexible, put springs on our steps and help the feet to carry the weight of the body.
A flat foot changes the way the person walks and stands. The foot will shift toward the inner side while walking. This is called overpronation.
This condition is normal in babies and toddlers, but it disappears after two or three years. Sometimes, it is hereditary but there are several ways to fix flat feet.
What Are the Types of Flat Feet?
The two types of flat feet are:
1. Flexible flat feet
2. Rigid or Inflexible flat feet.
Flexible Flat Feet
This is a type of flat feet which is visible when a person stands and disappears when the person sits.
It is common in children and can disappear when they are about two or three years old.
Some children don’t outgrow the flexible foot and have flat feet in adulthood.
Children suffering from genetic disorders like Down’s Syndrome are more likely to develop this type of flat feet.
This type of flat feet cause no pain or show any symptoms. It does not require medical attention or physical therapy unless pain occurs after walking, running or sports activities.
This disorder can be corrected by stretching the calf muscles, rolling a ball under feet, feet clenching, walking and standing on the toes, and shoe modifications.
Rigid Flat Feet
This happens as a result of disorders in feet development. The two main disorders that can result in rigid flat feet are:
This video explains how the change in position of the talus bone can cause fallen arches.
This occurs when the talus is pointing in the wrong direction and the bones that are supposed to be in front of it, is positioned above it.
A talus is a small ankle bone that is between the shin and the heel bone.
In vertical talus, the talus point towards the ground instead of pointing towards the toes.
After some time, thick skin patches will occur on the feet and cause difficulties when shoes are being worn.
Most times, the condition is treated by surgery from the age of 2-6 years. Corrective surgery can be performed in adulthood if the problem reoccurs.
This deformity has a less severe form called the oblique talus.
This happens when a joint is not formed but a rigid bone or fibrous material is formed instead.
When a rigid bone is formed instead of a joint, it is called a bony coalition while the forming of a fibrous structure is known as a fibrous coalition.
These bony coalition disorder form at birth and the two types of tarsal coalitions are the talocalcaneal and calcaneonavicular coalitions.
The talocalcaneal coalition involves the talus and calcaneus bones while the calcaneonavicular coalition involves the calcaneus and navicular bones.
What are the Causes of Flat Feet?
Causes of Flat Feet are:
- Bone deformation at birth
- Nerve disorders
- Rheumatoid Arthritis
- Inflammation of the tendons
- Ehlers-Danlos Syndrome
- Muscular dystrophy
- Cerebral palsy
Pronation is the ability of the feet arch to flatten and absorb shock. This occurs when the feet hit the ground while running, jumping, and walking.
In a flat feet condition, it overpronates. This makes the arch fall flat as the feet hit the ground.
Due to this, the fallen arches find it difficult to absorb the shock from body movements, thereby stressing the leg.
What are the Symptoms of Flat Feet?
The symptoms of flat feet are:
ii. Inflammation of the Achille’s tendons
iii. Achy feet and arches
v. Foot pain
vi. Difficulty in tiptoeing
How Can You Fix Flat Feet?
You can fix flat feet using the following methods:
- Arch Exercises.
- Going barefoot.
- Shoe inserts or orthotic insoles.
It is possible to correct flat feet through exercises that can fit into daily routines. These exercises are recommended for at least thrice per week.
It would take weeks of consistent workout before results are visible. Some of the exercises are:
In a sitting position, place a golf or tennis ball under the left foot. Roll the ball under the foot especially on the arch, for three minutes while keeping a straight back posture and spine.
Repeat on the right foot.
Rest your hands on a shoulder or wall and place a leg forward. Leave a leg stretched behind.
With both heels pressed firmly on the floor, push your body towards the wall. The leg extended backward should feel stretched and the front leg should be bent forward.
Maintain this stretch for thirty seconds and do it for each side four times.
In a standing position, press the big toe on your left leg to the floor and raise the other four. Hold it for five seconds.
Relax all the toes, then press the four toes to the floor and raise the big one.
Repeat the exercise on the right foot. Do it 10 times for each foot.
Put a towel under the feet. Squeeze up the towel by curling the toes while keeping the heels firmly on the floor.
Squeeze in as much towel as possible on the arch. Stay for five seconds before releasing the squeeze. Repeat fifteen times.
Stairs Arch Raises
Climb onto a raised platform on a tiptoe. Then relax and drop the right heel below the platform level while using the left heel as a balance.
Rotate the left knee sideways so that the arch is curved inwards. Repeat this exercise while alternating the foot for at least ten times.
Using a wall as support stands on a high tiptoe for five seconds. Relax and repeat for at least fifteen times.
Stand straight with the toes pointing forward and legs close together. Move the bodyweight to edges of the feet while curving up the arch and widening the gap between the legs.
Relax and repeat for twelve to fifteen times.
This is usually the last option and is used only in extreme cases. Different surgical procedures can be used to correct fallen arches. Some of them are:
This is done by removing and replacing an unhealthy tendon with a tendon taken from another part of the body.
If the tendon is healthy but inflamed, it is cleaned and attached to another healthy tendon.
Every muscle has an origin (starting point) and narrows down into a tendon that attaches to a bone.
During tendon transfer, the origin of the muscle, nerves connecting to the muscle and its blood supply are not tampered with.
The tendon attachment point to the bone is removed and attached to a different bone or tendon.
The Flexor Digitorum Longus tendon (FDL) is the tendon that bends the little toes and acts the same way with the posterior tibial tendon.
It could be used to replace the posterior tibial tendon.
This is the cutting, adjustment or reshaping of the calcaneal (heel bone) in the feet.
After the surgery, metal screws or metal plates are used to hold the heels in place for 6 weeks.
Shoes and other pressures can be applied on the feet after 8 weeks. Recovery could be achieved fully after 12 months.
Lateral Column Lengthening (Evans Osteotomy):
This lengthening is done by inserting a bone grate on the lateral column.
A cut is made on the heel and a bone from the hip or a cadaver is inserted on the heel bone (calcaneus).
A metal plate and screw is used to hold the bones in place.
The bone graft will fuse with the heel bone as time passes.
This surgery is sometimes done alongside calcaneal osteotomy. The lesser the bodyweight is borne by the heel, the faster the recovery time.
Shoes can be worn after this surgery after 12 weeks and full recovery time is usually after one year and six months.
Double or Triple Arthrodesis
This is the joining of one or more joints. This procedure helps to relieve pain, correct flat feet, arthritis, and genetic disorders.
It is normally the last option in flat feet treatment.
Triple arthrodesis is used to join the 3 main joints of the hindfoot. These are the calcaneo-cuboid joint, the talonavicular joint and the subtalar joint.
After administering an anesthetic, the surgeon will make a cut below the ankle on both sides of the foot.
All the cartilages on these joints are removed. Staples are used to making the joints stable and a bone graft is put on the spaces between the bones.
It takes around 8 weeks to start weight- and eighteen months to fully recover.
People generally believe that flat feet always need support. This is not entirely true.
When walking barefoot, the feet muscles become stronger and more active.
Because all the tendons in the feet and the arches move, going barefoot makes it more likely to have better stride in running and walking.
Taking shorter steps and a straight walking and running posture can help to strengthen the muscles of the feet.
Shoe Inserts or Orthotic Insoles
This is designed to provide the user with arch support, odor protection, and moisture absorption.
It also helps to align the feet to a more comfortable gait. It also relieves pain, discomfort, and helps the user to walk longer distances than before.
What are the Advantages of Flat Feet?
The advantages of flat feet are:
- They are more flexible than flat feet.
- They have more stability in combat.
- They adapt easily to uneven terrain.
What are the Disadvantages of Flat Feet?
The disadvantages of flat feet are:
- Foot pain and aches.
- Inability to properly distribute body weight.
- Plantar fasciitis (strain on the plantar fascia).
To know all about flat feet, the causes and ways to manage them, check out these articles:
- What Are the Best Insoles for Flat Feet
- How to Fix Flat Feet with Surgery
- What Are the Best Shoes for Flat Feet
- How to Wear High Heels with Flat Feet
- What To Do About Flat Feet Pain – The No Surgery Approach
- Why Are Flat Feet Bad for The Military?
How To Fix Flat Feet — Related FAQs
Can flat feet be corrected in adults?
Flat feet can be corrected in adults. It can be done using insoles, foot tapings, foot strappings, medications for pain relief, braces, and in extreme cases, surgery.
You have to be diagnosed by a podiatrist to determine if you have flat feet. Your doctor will also find out if your flat feet are flexible or rigid.
When that is done, the type of treatment to be used in correcting your flat feet is adopted by your doctor.
However, flat feet in adults is commonly corrected with the use of prescribed orthotic insoles.
Can flat feet be corrected?
Flat feet can be corrected using exercises, physical therapy, orthotic insoles, stability shoes, and surgery.
The exercises should be done at least 3 times a week to achieve positive results. Some of the feet exercises are heel stretches, arch lifts, ball rolls, calf raises, stair calf stretches, toe raises, and towel curls.
If the flat feet are caused by accidents or injuries, physical therapy can be used to correct them. If they are caused by deformities from birth or, orthotic insoles or surgery can be used.
However, it is best to talk to a foot doctor who will carry out tests to find out the type of flat feet you have and the best way to correct them.
Can you rebuild arches in flat feet?
You can rebuild arches in flat feet using feet exercises and physical therapy. Flat feet is a condition where the arch of the feet falls and all the surface of the sole is in contact with the floor.
The cause of the flat feet has to be known before choosing the exercise to use and the duration. There are a number of factors that can lead to flat feet. Some of them are weakness of the foot muscles, stiff ankles, supination of the forefoot, weak calf muscles, and bad walking posture.
Some of the flat feet exercises are calf stretches, toe raises, towel curls, heel raises, and toe yoga.
How do I get arch support for flat feet?
You can get arch support for flat feet by using orthotic insoles. Some insoles are sold over the counter while others are custom made to suit your needs.
You need to diagnose yourself or get tested by a podiatrist to find out if you have flat feet. The test could be a footprint test, shoe inspection or imaging examination. Custom-made insoles are then manufactured using the measurement of your feet.
The designs are made to specifically support the arches of your feet, add stability and comfort too.
Can flat feet be fixed with surgery?
Flat feet can be fixed with surgery. It is usually the last resort for the treatment of flat feet.
It is also used especially when the flat feet cause severe pain and orthotics do not provide comfort.
If the flat feet are diagnosed to be caused by tendon damage, arthritis, and foot deformity, surgery can be used to correct it.
Flat foot surgery procedure is done by giving an anesthetic injection on the foot. This will help to reduce the pain felt during and after the surgery.
How do I know if I’m flat-footed?
You can know if you are flat-footed by wetting your feet and standing on a flat surface. If the outline is not narrow towards the midfoot, you may have flat feet.
You can also inspect your shoes. If the inner part of your shoe sole is worn out or is leaning inwards, you may have flat feet.
To be sure, you should visit a foot doctor for tests such as X-ray, and the tiptoe test. Remember that flat feet not accompanied by any form of pain and discomfort do not need medical attention.