Flat feet is the most common foot deformity known. In fact, sixty million Americans or 25% of the U.S. population have flat feet. Some of these people may experience problems that limit their activities, while others can run marathons or play in the NBA.Causes
At the other end of the spectrum, yet within the same category of congenital flat foot, exist several rare, more severe forms of flat foot. These severe conditions include Vertical Talus, Congenital Calcaneal Valgus, and Tarsal Coalitions - all of which are more rigid (no arch with or without weight on the foot) and definitely symptomatic. Luckily, these are much less common, but can usually be identified by specialists at the time of presentation and treated appropriately. The second category, acquired flat foot, develops over time, rather than at birth. Many different factors can contribute to the development of flat feet. These include the types of shoes a child wears, a child's sitting or sleeping positions, compensation for other abnormalities further up the leg, or more severe factors such as rupture of ligaments or tendons in the foot. Very commonly, the reason for flat feet is that the foot is compensating for a tight Achilles tendon. If the Achilles tendon is tight, then it causes the foot to point down, or to plantarflex (as occurs when stepping on the accelerator of your car). Even minimal amounts of plantarflexion can simulate a longer leg on that particular side, assuming that the other foot is in the normal position. The body therefore tries to compensate by pronating, or flattening out the arch, thereby making up for the perceived extra length on the affected side.Symptoms
Pain in arch of foot is really the only symptom of this condition. It is unlikely to see any swelling or bruising and instead there will be a deep tender spot near the heel. Occasionally the pain may radiate further down the foot. With this condition, pain will usually be felt first thing in the morning or after periods of sitting. This is because the plantar fascia tightens and shortens slightly when there is no weight on it and by standing on it it suddenly stretches and becomes painful. After a few steps it starts to loosen off and the pain may subside. If this is the same pattern of pain you experience it is quite likely you have plantar fasciits. Pain may also be felt when walking up stairs or standing on tip-toes (anything that stretches the fascia).Diagnosis
The medical practitioner will examine how the muscles of your foot function. These tests may involve holding or moving your foot and ankle against resistance; you may also asked to stand, walk, or even run. Pain caused by movements may indicate the cause of the pain. The nerves in the foot will be tested to make sure no injury has occurred there. An x-ray, MRI, or bone scan of the foot and arch may be taken to determine if there are changes in the makeup of the bone.Non Surgical Treatment
Stretch the fascia. Prop your toes up against a wall, keeping your arch and heel flat so the toes stretch. Hold for a count of 10. Repeat 10 times three or four times per day. Roll a frozen water bottle under the arch. Stretch first then roll out the arch for 10 minutes; you don?t want to stretch the tendon when it?s ice cold. Freeze a golf ball and massage the fascia. Roll the frozen golf ball under the foot, starting from the front and working your way back. Put good pressure on each spot-the medial, center and lateral positions-for 15 seconds before moving to the next area. Then, roll the ball back and forth over the entire foot. Foam roll all muscles on the body above the plantar. Even tight shoulders can cause the condition, as your arm swing can throw off proper hip alignment and footstrike. Bump your arch. Get a commercial insole with an arch bump to push on the plantar and keep it from flexing-it doesn?t matter if you?re an under or overpronator; the plantar needs to be supported and strengthened, Wear the support in all shoes, if possible.Surgical Treatment
Patients with adult acquired flatfoot are advised to discuss thoroughly the benefits vs. risks of all surgical options. Most procedures have long-term recovery mandating that the correct procedure be utilized to give the best long-term benefit. Most flatfoot surgical procedures require six to twelve weeks of cast immobilization. Joint fusion procedures require eight weeks of non-weightbearing on the operated foot, meaning you will be on crutches for two months. The bottom line is: Make sure all of your non-surgical options have been covered before considering surgery. Your primary goals with any treatment are to eliminate pain and improve mobility. In many cases, with the properly designed foot orthosis or ankle brace, these goals can be achieved without surgical intervention.Prevention
Because most cases of flatfeet are inherited, the condition is usually impossible to prevent. Even when children with flexible flatfeet are treated with arch supports and corrective shoes, there is little evidence that these devices prevent the condition from lasting into adulthood.