A flat foot is a postural deformity in which the arches of the foot collapse, with the entire sole of the foot coming into complete or near-complete contact with the ground. Flat feet or fallen arches are pretty common among children up to the age of six years. The development of the arch usually starts from the age of seven years. Approximately 20 - 30% of the general population have an arch that simply never develops in one or both the feet. Also studies have shown that 90% of kids with BMI above normal have flat feet. Flat feet are also referred to as pes planus, posterior tibial tendon dysfunction, and fallen arches.
The arch on the feet acts as an elastic that provides a spring to the step and helps in distributing the entire body weight across the feet and legs. The structure of the arches determines how a person walks. The arches need to be both sturdy and flexible to adapt to stress and a variety of surfaces that we walk on like grass, sand, hard floor etc. A human foot has about 33 joints, which holds 26 different bones, 100 muscles, tendons and ligaments together and anything that interferes with this anatomical structure leads to flat feet.
In general flat feet can be classified into two types - flexible flat feet and rigid flat feet. In flexible flat feet, the feet have a normal arch when the person is sitting, but disappears once the feet come in contact with the ground. However if there is no arch, whether sitting or standing, they have a rigid or true flat feet. Flexible flat feet is also known as paediatric flat feet because it is apparent in childhood and most probably will become a normal arch as the child grows older. A rigid flat foot mainly develops in adults as a result of weakening of the tibialis posterior muscle tendon, which is a major supporting structure of the foot arch. It is a condition that leads to flattening of the arch and rolling in of the ankle. It is a progressive deformity with early symptoms of pain and swelling at the inside of the arch of the foot and ankle. It eventually may lead to arthritis of the foot and ankle joints. Flexible flat feet is usually in both feet whereas posterior tibial tendon dysfunction or adult acquired flat feet can occur in one or both feet.
A flat foot is further classified as mild moderate and sever. A mild flat foot is where the arches completely or near completely touch the ground. A moderate flat foot is the one in which the ankle rotates inward and has a slight deviation from the normal neutral foot, this is called as pronation.
Sever flat foot or over-pronation is the case when the feet roll inwards too much, past the point necessary for shock absorption. At this point, the ankle joints are extended, causing the lower leg bones, and subsequently the upper leg bones to rotate inwards. This places stress and can cause pain on the ankles, lower leg muscles, knee joints, and hips.
It is commonly observed that people with flat feet start complaining about heel, knee and ankle pain, but the fact is that the health issues that are usually faced is not because of the flat feet by itself but of pronation. Now the question arises – if flat feet don’t hurt why we should get it treated. Research also shows that only one or two out of every 10 children continue to have flat feet even in adulthood. Answering the question if flat feet are left undetected at an early age, there is a high chance of deformity in the leg and foot over a period of time. Ignoring flat feet will also lead to pain in the ankle, knee and back. If the person is overweight then that combined with flat feet will result in the early onset of arthritis. The most common treatment for flat feet is orthotic devices and insoles. The orthotic devices are customised as per the requirement and severity of the person’s foot. While a good pair of insoles will help to provide firm support for the heel, arch and sometimes even the metatarsal bones as well as heel stabilisation to help prevent over pronation and increase shock absorption. Insoles can also be customized as per the requirement so as to provide support for the foot. To conclude a flat foot is a common disorder that might not be painful at the onset but definitely needs to be identified and corrected at the earliest. At Rehamo we do offer a free assessment of the feet and also give in customized solution to the users as per their requirement.