Flat Feet Advice

Flat feet is also know as pes planus, adult acquired flat foot deformity, progressive flat foot deformity, posterior tibial tendon dysfunction (PTTD), flat foot, splay foot, fallen arches (loss of medial longitudinal arch of foot).

Flat feet are characterized by a a flattening the the medial longitudinal arch (inside foot arch). This causes the foot to roll in excessively in order for the boy to maintain stability. This excessive internal rotation occurs at the subtaler joint in the ankle and is known as over pronation.

The image below shows a patient with a severe flat foot deformity with associated over pronation.

Causes

Flat feet can occur in all age groups but tends to be common in individuals that do little or no physical activity and gain weight which disturbs normal foot Biomechanics and leads to flat feet.

Flat feet can also be a congenital condition (you are born with flat feet) or can be as a result of either walking or running on hard surfaces. This repetitive micro trauma causes weakening of the posterior tibial tendon - PTT which hold the arch in position.

The PTT may also be damaged by specific conditions that can cause the condition such as:

Fractures and trauma (e.g. transection of the tendon)
Dislocation of the mid-foot bones
Neuropathy leading to painless disorganization of the bones (e.g. Charcot joint in diabetic neuropathy)
Arthritis affecting the relevant foot joints (e.g. in rheumatoid arthritis)
Obesity
Pregnancy

Symptoms

• Aching feet when standing, along the foot's medial border and medial aspect of the ankle
• Swelling of the midfoot on standing
• Visible deformity of the foot on standing with the medial border of the foot being tipped towards the floor
• The patient may be limping due to the loss of 'push-off' strength of the foot
• Patient notes that they walk on the inside of their foot and quickly wear out or squash the medial aspect of the soles of their shoes
• Advanced cases may note pain in the lateral ankle due to increased pressure between the calcaneus and fibula

Signs

• Look at shoes for evidence of excessive wear/squashing of mid sole along the inside border of the heel and midfoot
• A [podiatrist may assess arch height
• The arch will be lowered and the forefoot abducted
• A podiatrist may look at the foot from behind to seek evidence of your heels rolling out which will signify over pronation.

• You may be asked the to stand on tiptoes on the affected foot alone (holding on to something solid for support) with flat feet the PTT will not allow the heel to twist in and may cause pain, difficulty in completing the task, or a complete inability to perform a single heel-raise.
• Swelling and fluid in the tendon sheath along the course of the PTT may be noted when examining the foot with the patient seated and foot above the floor.

Further Problems

It is vitally important that treatment for flat feet is sought as this condition can cause a whole host of foot, leg, pelvic and back conditions. Problems such as:

Corns and Calluses
Plantar Fasciitis (heel pain)
Patello-Femoral pain (knee pain)
Achilles Tendonitis (ankle pain)
Morton's Neuroma (swollen trapped nerve)
Hallux Abducto Valgus (bunions)
Metatarsalgia (ball of the foot pain)
Shin pain
Lumbo-Sacral Pain (lower back pain)
Aching legs

Prevention & Treatment Options

Pes Planus can be effectively treated with orthotics (special insoles) that provide biomechanical support and help feet to function more efficiently. The most effective orthotics are those which are custom made to fit your foot, but in many cases a non-prescription orthotics or insoles can be used.

The orthotic should provide arch support to combat over pronation. Orthotics should be combined with supportive footwear that fits the foot correctly and contains a firm, low heel.

Dr Foot's Sport Insoles (pair)

Dr Foot's Sports Insoles work wonders on problem-prone feet. These revolutionary Insoles are biomechanically engineered to help relieve flat feet. You will feel an invigorating difference with every step you take!

The contoured shape supports your feet in two directions, both lengthwise and across the arch, for maximum relief of pain and fatigue. The special poron heel cushion and the comfortable arch support helps to reduce shock absorption and fatigue.

Click here to view the Sports Insoles

Dr Foot Pro Insoles (pair)

Flat feet sufferers find extra support in Dr Foot Pro Insoles.

If you suffer from flat feet, you've found a friend in these ultra-supportive foot supports. The soft cover and the flexible EVA base material create an excellent arch support which immediately treats the cause of the flat feet.

They help reduce stress at key weight points, keep each foot properly aligned and cradle and stabilize your heels. A strategically placed heel insert made of poron foam absorbs the pounding foot shock of each step.

Click here to view the Pro Insoles

Dr Foot Work Insoles (pair)

Designed specifically to fit into work boots and shoes. These dynamically engineered functional insoles correct alignment of the foot & ankle providing comfort and relief for people who are on their feet all day.

The special poron heel cushion and the comfortable arch support helps to reduce shock absorption and fatigue. Sports Injuries and foot pain occur when there is poor alignment of the feet.

Click here to view the Work Insoles

Dr Foot Custom Insoles (pair)

This unique heat mouldable insole provides customised support with added thickness and optimum support to treat a variety of foot and leg conditions.

Our Dr Foot Custom Insoles cost less than traditional custom orthotics because they use a special heat to fit technology. Heat to fit technology allows everyone to get a custom fit without the high cost associated with visiting a health care professional. Dr Foot Custom Insoles are truly a revolution in foot care technology!

Dr Foot Custom Insoles are designed to treat over pronation and provide maximum support. Ideal for patients seeking arch support for prevention and treatment of flat feet.

Click here to view the Custom Insoles