Flat feet, also known as pes planus, are present in nearly three out of every ten individuals of the general population. This defect in anatomical structure is characterized by an almost complete or total contact of the foot with the ground; the arch between the heel and toes is missing. Flat feet may be present from birth or the defect may appear with age or due to injury. Obesity and diabetes are other factors that result in flat feet. Babies and toddlers normally have flat feet. This is because the arches in their feet are not fully developed. Sometimes, flat feet appear in adults because the arches collapse due to age. The condition requires treatment when it causes pain, knee discomfort, or ankle problems.
Rigid and Flexible Flat Feet
Flat feet may either be flexible or rigid. The former condition is the more commonly found type and occurs only when the foot has to bear weight. With the latter type, the foot does not display an arch under any condition. A rigid flat foot can result from arthritis, which may be present from birth, may occur due to conditions that cause muscle problems, or may manifest due to a tarsal coalition. Often, flat feet present in children disappear as the kids grow. Flat feet, particularly the flexible type, are painless and do not require any kind of medical treatment. Rigid flat feet can lead to pain, particularly if the person is physically active.
Symptoms of Flat Feet
Symptoms of flat feet include pain in the feet, particularly in the heel or arch region of the feet. Ankles may swell. Tendons around the heel tighten with activity. The insides of the sole may get inflamed. Standing or walking on tiptoes may be uncomfortable.
How to Improve Flat Feet to Minimize Stress and Pain
Orthotic footwear helps cope with flat feet. You can also have bespoke corrective footwear made. For most people, a little research will allow them to buy good running shoes for flat feet without having to spend on custom footwear.
Choose shoes that are designed to help with foot-related issues, such as mild or major overpronation and absent or underdeveloped arches. The shoes must be comfortable, and if required, have the space to allow for removable insoles.
Fortunately, it is easy to buy sneakers, jogging shoes, boots, dress shoes, sandals, etc. with the right features incorporated to help you go through the day without pain and in style.
Flat feet tend to be longer and wider. When purchasing shoes, it is essential to consider the width as well as the length of the feet. Loafers with an insole to support the arch, and a round toe box can give your toes wiggle room. They are an option that’ll work for casual and semi-formal occasions.
You can also buy orthotic bathroom slippers and sandals for the beach that are designed to support the arches, absorb shock, and minimize the load on the feet and ankles.
Running and jogging shoes use different materials and technologies to achieve common ends, namely comfort, arch support, reduction in overpronation, and heel support.
How to Choose the Right Shoes for Flat Feet
Appropriate footwear plays an important role in treating flat feet. Footwear with arch support insoles or other orthotic devices provides cushioning and manage pronation. By boosting the arch, such shoes reduce friction between the feet and shoes, reduce the load on knees, spine, and ankle, and absorb the shock from movement. Flat feet do not maintain a neutral position that is in alignment with the rest of the body. Such feet roll inward and do not contribute to shock absorption. Orthotic shoes can provide soft and rigid support to the feet to compensate for the absence of an arch.
People with flexible flat feet or with minor rigid flatness of the feet can opt for casual shoes that are comfortable and possess a sturdy heel counter. Consider shoes with removable insoles that can be replaced as and when required. Apply similar due diligence when buying high heels, clogs, and such casual footwear.
Orthopedic shoes are prescribed for those with a severe flat foot problem. While these shoes address issues arising from the deformity, these shoes with design features such as steel shanks and hard-heel counters are stiff and do not easily accommodate the natural flex of feet when walking. Choose shoes with padded collars and durable insoles. The design of these shoes precludes a pleasing appearance, another reason why people avoid buying such shoes.
Select running shoes that improve stability. People with flat feet experience difficulties in maintaining their balance because of ankles that turn inward when walking and running. This increases the chances of injuries over time. Stability running shoes are made using comfortable lightweight materials, and their performance can be further enhanced by inserting removable arch-supporting insoles.
In order to improve flat feet, look for shoes that have:
- Supportive sidewalls for better stability.
- A wider outsole for heel support.
- A soft insole on top of a midsole with soft and hard regions.
- Firmer inner midsoles as compared to the outer portion of the same.
- Molded heel counters for heel support.
- Flexible uppers.
Diagnosis of Flat Feet
Flat feet can be diagnosed by a visual examination. Techniques used to visually ascertain flat feet include the wet footprint test, shoe inspection, checking for overpronation by counting number of toes visible when seen from behind, and checking for an arch when a person stands on tiptoe.
The subject is asked to describe the type of pain – dull, sharp, or throbbing. The doctor may enquire about activities that exacerbate the pain or lead to a reduction in discomfort.
Imaging tests are carried out to understand how the condition affects the mechanics of the feet. X-rays assist in confirming arthritis as a cause. CT scans inform about the foot’s structure from multiple angles. Ultrasounds can detect injury to soft tissue, and help corroborate or negate tendon injuries as a probable underlying cause of flat feet.
Research shows that males with a higher body mass index are likelier to be more predisposed to this condition. Even otherwise, more men than women are affected by pes planus.
Treatments Available to Improve Flat Feet
The treatments used depend on whether the patient is a child or an adult. As a rule of thumb, doctors prefer to resolve the condition using conservative treatment methods. Surgery is reserved as the last option.
Treating Flat Feet in Children
Often, flat feet in children disappear and the arches appear by the time the child reaches adolescence. A child that walks and runs barefoot on different surfaces, such as dirt, downhill, uphill, carpets, etc. is more likely to have a normal foot development. Orthotics are a treatment option for children born with flat feet. Once surgery is done, then corrective orthotics are prescribed to ensure that the feet develop correctly. Regular, long-term follow up after pediatric treatment for flat feet is not usually required.
Treating Flat Feet in Adults
One out of four adults diagnosed with flat feet will feel pain in the feet. The majority of people with flat feet do not need any kind of treatment. Pain killing tablets are often the only medication required to manage the condition. If the symptoms persist, then other treatment alternatives can be pursued.
Orthotic supports can gradually alter the structure of the feet. Such supports may have to be worn for life.
The doctor may prescribe exercises for the feet to improve the flexibility of the arch and also strength in the feet. Podiatrists may also recommend beneficial yoga postures and stretches. Massages to stimulate blood flow and ease off the pain in the muscles help as well. A period of rest may be prescribed to allow the feet and joints of the lower limbs to recover from the pain arising from misaligned locomotion and poor form during running, both of which arise from flat feet.
Since, obesity is an important causative factor, doctors may advise obese patients to lose weight. Care must be taken to ensure that physical activities performed do not stress the ankle joints and knee joints.
Surgery is the last option, and can permanently correct a flat foot. It is possible to surgically build an arch in feet where none has existed. Surgical procedures will vary, depending on the degree of flatness and deformation, patient’s age, and overall health.
Reconstructive surgery is one option that aims to realign the tendons and bones of the feet. Another approach, the subtalar implant, is used to offer support to the arch. Recovery from foot surgeries takes time. Getting medical claims reimbursed after a foot surgery is not easy because insurance companies choose to consider surgery as the very last option. The subject needs to have all the papers, prescriptions, reports, and receipts handy. Surgery is not commonly prescribed for flexible flat feet; however, if the condition has been caused by bone or tendon abnormalities, then these can be corrected surgically.