Flat feet are a common condition in which the arches of the feet are curved, causing the entire bottom of the foot to touch the ground. Through the Dalili Medical website, we review the different types of flat feet, their causes, and whether they are genetic or caused by injury. We also discuss the symptoms of this condition and how it can affect balance and cause pain, in addition to methods for diagnosing it. We will also discuss the available treatment options, including corrective medical devices, physical therapy, surgery, lifestyle changes, and medications.

What is flat feet?

 

Flat feet, or flat feet, is a condition characterized by one or both feet being flat. This can be noticed when standing and putting pressure on the feet, as the foot is flat and does not have the usual arch. Although the arch may sometimes appear when lifting the foot. All children are born with flat feet, as the arches usually form by the age of six. In most cases, flat feet are not a problem, but if they cause pain or other problems, some treatments can be resorted to.

### Causes of flat feet

 

Flat feet occur as a result of the relaxation of the ligaments in the sole of the foot, which leads to the loss of the natural arch in the sole of the foot. The following are the most prominent causes that may lead to the relaxation of these ligaments and thus flat feet:

1. **Genetic factors**: Genetic factors are considered a common cause of flat feet. If one of the parents suffers from relaxation in the ligaments and tendons in the bottom of the foot, this may be inherited by children.

2. **Musculoskeletal disorders**: Musculoskeletal disorders can lead to relaxation of the ligaments and tendons in the bottom of the foot, which prevents the formation of the arch and leads to flat feet.

3. **Foot or ankle injuries**: Injuries to the foot area may lead to ligament tears and relaxation of the arch in the sole of the foot, leading to flat feet.

4. **Rheumatoid arthritis**: Rheumatoid arthritis is an inflammation that affects the lining of the joint, causing damage to the cartilage, tendons, and bones surrounding the joint in the foot. Tendon damage causes the arch of the sole of the foot to relax, contributing to flat feet.

5. **Some diseases of the nervous system or muscles**: Diseases of the nervous system or muscles are possible causes of flat feet, especially in cases of cerebral palsy and muscular dystrophy.

**Tarsal coalition:** Tarsal coalition is a medical condition that leads to abnormal fusion of the bones of the foot, resulting in stiffness and flatness of the feet.

**Diabetes:** Diabetes causes muscle disorders that lead to damage to the nerves and tendons, especially in the foot area, making it one of the factors contributing to the appearance of flat feet.

**Obesity or pregnancy:** Excessive pressure on the soles of the feet, whether as a result of obesity or pregnancy, can cause the foot to bear a lot of weight, causing the tendons in the sole of the foot to stretch and lead to flatness.

**Tendinitis:** Inflammation of the tendons in the foot can cause damage to the tendons, leading to relaxation of the arch in the sole of the foot and flatness.

**Tight shoes:** Tight shoes can lead to foot deformities, including flat feet, especially in childhood when the bones are soft and easily affected by tight shoes.

What are the possible causes of acquired flat feet in adults?

 

There are several factors that may lead to the appearance of acquired flat feet, including:

- **Weakness of the posterior tibial tendon**: The posterior tibial tendon raises the arch and supports the foot during walking. If this tendon is torn or stressed, the arch may collapse.

- **Arthritis**: Conditions such as rheumatoid arthritis can contribute to acquired flat feet, as they affect the ligaments that support the foot and the cartilage in the joints, which leads to a change in the shape of the foot and makes it flat.

- **Injuries**: The ligaments in the foot may be torn or injured, leading to deviation of the joints and flattening of the foot in the middle area and sometimes in the back.

- **Charcot foot**: Some diabetics suffer from a condition known as Charcot foot, which can lead to foot deformity. These patients lack normal sensation in the foot, preventing them from feeling pain when the arch collapses.

Types of flat feet

Types of flat feet include:

1. **Flexible Flatfoot**: This is the most common type, where the arches in the feet can be seen when not standing, and disappear when pressure is applied to them. Flexible flatfoot usually appears during childhood or the teenage years, and affects both feet, with the condition gradually increasing with age. The tendons and ligaments in the arches of the feet may be stretched and swollen.

2. **Rigid Flatfoot**: In this type, the foot remains flat in all positions, where the flatfoot can be seen while sitting, standing, or putting pressure on the feet. This condition often develops during the teenage years and gets worse over time. Rigid flatfoot may cause pain, and it is difficult to bend the feet up or down or move them side to side, and it can affect one or both feet.

Acquired flatfoot, also known as fallen arch, is a type of flatfoot that occurs when the arch of the foot unexpectedly drops, causing the foot to turn outward and may cause pain. It can affect only one foot, and inflammation or rupture of the tendon in the shin that supports the arch is the most common cause.

Vertical talus, also known as rocker-bottom foot, is a condition that some children suffer from as a result of a birth defect that prevents the arches from forming. In this condition, the ankle bone is out of position, causing the bottom of the foot to resemble the bottom of a rocking chair.

Can an orthopedic surgeon orCorrecting the Arch Correcting the Foot?

 

Yes, an orthopedic surgeon or chiropractor can help correct a collapsed arch using custom insoles, also known as shoe inserts, that are designed to provide support and improve foot balance. They can also guide you through exercises and stretches to improve foot strength and flexibility.

Is flatfoot a disability?

 

No, flatfoot is a foot deformity but it is not a disability.

Will my child have flatfoot as they grow older?

 

Most cases of flatfoot in children resolve on their own without treatment. If your child develops any pain or symptoms, it is best to start treatment early to ensure an effective response to flatfoot treatment. In some cases, the arch of the foot may not form until childhood or adolescence, but as with children, flatfoot in adults often does not require treatment unless symptoms or pain are present.

When does a child with flatfoot need surgery?

 

Surgery is needed if the pain persists and the condition does not respond to conservative treatment, or if conservative treatment is not possible, such as bone injuries or ligament tears.

Can flat feet be hereditary?

 

Yes, flat feet may have a genetic aspect, as genetics play a role in determining the structure and orientation of the foot. Individuals with a family history of flat feet or genetic conditions that affect foot health are more likely to develop this condition.

Genetic factors affect the height and flexibility of the arch of the foot, which affects weight distribution when standing or walking. Studies have shown that some genes may predispose individuals to structural problems such as flat feet, highlighting the importance of understanding family medical history when assessing foot health.

Genetic conditions such as Ehlers-Danlos syndrome or Marfan syndrome can contribute to the development of flat feet by affecting the connective tissues. Therefore, preventive measures such as wearing appropriate shoes and providing medical support may help manage the symptoms associated with hereditary flat feet.

Do flat feet develop over time?

 

Flat feet can develop or worsen over time due to factors such as poor foot health, abnormal foot posture, altered foot mechanics, and improper gait. Regular gait analysis and postural balance assessment can help monitor and manage the progression of flat feet. Changes in the structure of the foot can put increased stress on surrounding tissues and joints, which can cause discomfort and impact overall mobility. As flat feet progress, individuals may experience problems with balance, stability, and even steering. This can result in a cascading effect, affecting the ankles, knees, hips, and even the lower back. By tracking gait patterns and ensuring proper alignment, preventative measures can be taken to address developing problems and improve foot function to maintain overall musculoskeletal health.

Can flat feet cause pain?

 

Flat feet can cause pain, especially in the arch or on the inner side of the foot. It is important to seek foot care to get an accurate diagnosis and treatment to manage this discomfort. Using arch support and proper footwear can help relieve pain and provide support for flat feet.

Flat feet are a common condition where the arches of the feet are flat, which puts increased pressure and stress on the arch area. This can lead to arch pain, which can range from mild discomfort to devastating pain. By consulting a podiatrist, people with flat feet can receive personalized care and treatment plans to relieve arch pain. In addition to professional care, incorporating pain relief methods such as ice therapy, stretching exercises, and over-the-counter medications can help effectively manage arch discomfort.

Can flat feet affect balance?

 

Yes, flat feet can affect balance due to changes in foot mechanics, ankle instability, and abnormal foot posture.

These changes result in an uneven weight distribution and lack of arch support, which negatively impacts the body’s ability to maintain balance. Poor ankle stability in people with flat feet can also increase balance problems, as the ankle plays a vital role in providing support and stability during movement.

Also, abnormal foot posture can contribute to imbalances in the lower body, leading to compensatory patterns that affect overall balance.

Balance exercises designed to strengthen the muscles in the feet, ankles, and lower legs can help improve stability and motor awareness in individuals with flat feet.

Corrective strategies such as orthopedic insoles and supportive shoes can also help correct foot posture and improve overall balance.

What tests are used to diagnose flat feet?

 

To accurately diagnose flat feet, healthcare providers perform a range of tests, including orthopedic evaluations, diagnostic imaging such as MRI, as well as foot mechanics and footwear evaluations. These tests help determine the severity of flat feet and the possible causes behind them.

Orthopedic evaluations include examining the structure and orientation of the foot, checking for any abnormalities or weaknesses that may contribute to flat feet. MRIs provide detailed information about the bones, ligaments, and tendons in the foot, helping to detect any structural problems.

Foot mechanics evaluations study how the foot works during movement, reviewing factors such as arch height and pronation. Shoe analyses evaluate the level ofSupport and cushioning provided by shoes, ensuring proper guidance and reducing pressure on the feet.

What are the causes and symptoms of flat feet?

 

Flat feet are related to problems with the tendons, ligaments and bones in the feet and lower legs, in addition to some diseases such as cerebral palsy, muscular dystrophy and spina bifida.

Risk factors that may increase the likelihood of flat feet include:

- Having a family history of flat feet.

- Exercising intensely, such as with children who play sports, which increases the likelihood of foot and ankle injuries.

- Obesity.

- High blood pressure.

- Diabetes.

- Previous injuries to the foot, ankle or heel.

- Rheumatoid arthritis.

- Pregnancy.

- Aging, due to weakness of the posterior tibial tendon.

- Tendonitis.

Another condition that can lead to flat feet is tarsal coalition, which causes the bones of the foot to fuse abnormally, making them flat. This condition is often diagnosed in children.

What are the signs of flat feet?

 

Most people with flat feet do not experience pain or other problems, but some types may cause pain. Symptoms of flat feet include:

- Leg pain

- Muscle pain or fatigue in the foot or leg

- Pain in the arch, ankle, heel, or foot

- Pain when walking or changes in gait pattern

- Toe deviation (where the forefoot and toes point outward)

What is the course of the disease in flat feet?

 

Most people with flat feet find relief from their symptoms with nonsurgical treatments, while others may not need any treatment at all. However, flat feet can increase your risk of developing certain problems, such as:

- Arthritis

- Bone spurs

- Tumors (such as big toe spurs) or calluses

- Lower back pain, thigh pain, or knee pain

- Leg problems

When should you see a doctor?

 

Anyone who experiences the following symptoms should see a doctor:

- Balance problems

- Difficulty walking, including pain when walking

- Stiffness and pain in the foot

- Sudden onset of flat feet (sudden falling of the arches)

**Damages of flat feet**

Flat feet and atrophy of the arches in the soles of the feet are more than just a deformity in the shape of the foot. The arch plays a vital role in distributing the body's weight evenly while walking, in addition to its function in absorbing shock when falling, which protects the spine from harm. Therefore, atrophy of the arch in flat feet may lead to many complications if treatment is ignored, including:

1. **Difficulty walking**: The absence of the arch in the sole of the foot prevents it from bending while walking, which may cause damage to the knee joint over time, and lead to severe pain during movement. Neglect may also lead to the pain being transmitted to the back and neck.

2. **Change in movement mechanics**: If flat feet are ignored, the way of movement may change, which may lead to limping or turning the knee inward while walking.

3. **Spine curvature**: The improper way of walking and standing resulting from flat feet leads to spinal curvature over time, causing severe pain in the back area.

4. **Plantar fasciitis**: People with flat feet are more susceptible to plantar fasciitis due to their walking style.

Tests to diagnose flat feet

During a physical exam, your doctor will examine the front and back of your feet and may ask you to stand on your toes to monitor the movement of your feet. Your doctor may also be interested in reviewing the styles of shoes you wear.

If you have severe foot pain, your doctor may recommend tests such as:

- **X-rays**: This type of imaging uses a small amount of radiation to produce images of the bones and joints in your feet, and is particularly useful in detecting arthritis.

- **Computed tomography (CT) scans**: In this test, images of your feet are taken using X-rays from multiple angles, providing more detail than traditional X-rays.

- **Ultrasound**: If your doctor suspects a tendon injury, he or she may order an ultrasound, which uses sound waves to produce detailed images of soft tissues inside the body.

- **Magnetic resonance imaging (MRI)**: This type of imaging, using radio waves and a strong magnet, provides precise details of internal tissues.

**Flatfoot Surgery**

Foot correction surgery is an option for treating flat feet, and is often only used in severe cases. Here is some information about flatfoot surgery:

**Who is a candidate for flatfoot surgery?** Flatfoot surgery is performed on individuals who have severe foot pain and have not responded to traditional treatments such as physical therapy and special exercises. Surgery is also the only effective option for chronic tendonitis in the foot.

**How ​​is flatfoot surgery performed?** Flatfoot surgery procedures vary depending on the cause of the flatfoot, but they typically involve reshaping the foot by repairing tendons, ligaments, and the bone structure, which helps create an arch in the sole of the foot.

**Success Rate:** Flatfoot surgery is a low-risk procedure when performed correctly, with a success rate of up to 90%.

**Risks of Flatfoot Surgery:** Potential risks of flatfoot surgery may include complications such as infection,Blood clots, or nerve damage. However, these risks can be reduced by adhering to the instructions of the treating physician.

**Recovery period*: The recovery period from flatfoot surgery and the ability to walk without the use of crutches usually ranges from approximately 3 to 4 months.

**How ​​can flatfoot be treated?**

 

**Choosing the right shoes:** If you suffer from flat feet, it is important to look for shoes designed for this purpose. These medical shoes are designed to relieve pressure on the sole of the foot and distribute weight evenly and comfortably.

**Stretching exercises:** Stretching exercises can help relieve the pain and symptoms of flat feet, in addition to improving the flexibility and strength of the foot. Massaging the muscles of the sole of the foot can also help prevent the foot from turning inward while walking.

**Avoid activities that increase pressure:** People with flat feet should avoid activities that may increase pressure on the sole of the foot, such as running or jumping, as this may worsen the pain and may cause serious complications to the spine.

**Physical treatments:** Physical treatments provided by a physical therapist can be effective in relieving the symptoms of flat feet and preventing serious complications.

**Support devices:** Silicone support devices can help straighten the bones and improve the shape of the foot when used regularly.

**Using anti-inflammatories:** If flat feet are caused by inflammation in the joints or tendons, taking anti-inflammatories prescribed by a doctor can relieve the symptoms of flat feet and reduce swelling.

**Weight loss:** Weight loss helps relieve pressure on the ligaments and muscles of the sole of the foot, which helps relieve the pain caused by flat feet and prevents the condition from worsening.

**Treatment of the causes of flat feet:** If flat feet are caused by diseases such as diabetes, arthritis or tendonitis, treating these diseases can help stop the deterioration of the foot and ligaments, making it easier to correct this deformity.

**Orthotic devices**

Therapeutic devices such as cushions, arch supports and custom braces are commonly used to provide proper support and alignment for people with flat feet. These devices can be integrated into shoes or customized to meet the specific needs of the foot, with shoes being able to be modified to suit the individual’s requirements. Therapeutic pads are designed to fit inside the shoe, providing support and comfort to both the arch and heel. Arch support mechanisms help distribute pressure evenly across the foot, reducing stress on the arch muscles. Therapeutic supports are customized to each individual, taking into account their unique foot structure and gait pattern, enhancing support and comfort. Shoe modifications, such as adding extra pads or adjusting the insole, can also enhance the effectiveness of therapeutic devices in improving foot alignment and reducing discomfort for people with flat feet.

**Physiotherapy**

Physiotherapy is an essential component of flat feet treatment, helping to strengthen the foot muscles, improve their mechanics, and enhance balance and stability. Therapists develop customized rehabilitation programs that include corrective exercises that target the biomechanical issues associated with flat feet. They work closely with patients to develop individualized treatment plans that aim to address the root causes of flat feet rather than focusing solely on the symptoms. Through targeted muscle strengthening exercises, physical therapists aim to correct imbalances in the feet and ankles, which contributes significantly to the overall health of the foot. Therapy sessions focus on promoting balance and self-awareness, helping individuals with flat feet regain control and stability in their movement. By incorporating a variety of modalities and techniques, physical therapists play a vital role in not only relieving pain, but also in preventing future foot complications in those with flat feet.

**Surgery**

In severe cases of flat feet that do not respond to conventional treatments, surgery may be recommended. Procedures such as foot reconstruction aim to correct foot orientation and biodynamics, with a focus on post-operative care to ensure healing and rehabilitation. Surgery can address issues such as posterior peg dysfunction in advanced flat feet. Foot reconstruction typically involves a variety of surgical techniques to reorient the structure of the foot, such as tendon transfers, bone resections, and ligament repair. After surgery, patients are advised to elevate and rest the foot, and weight-bearing activities are gradually introduced under the supervision of a physical therapist. The recovery period may vary, with full weight bearing usually being restored between 6 to 12 weeks after surgery. It is essential to address the dysfunction of the posterior tibial peg, as this helps restore proper arch support to the foot, which improves overall biodynamics and reduces pain. Patients may also benefit from using orthotics or special shoes after surgery to maintain corrected orientation.

**Medications for flat feet**

If the child is experiencing pain, the doctor may recommend medications to relieve it, such as non-steroidal anti-inflammatory drugs, most notably ibuprofen, which help relieve pain and reduce swelling. These medications should not be taken without consulting a doctor, especially if there is a stomach ulcer or kidney problems.

**Splints and braces for flat feet**

In some cases, the doctor may recommend using a splint for a short period to provide comfort and support for the foot.

**Orthotics**

Orthotics can be helpful in reducing pain, which are a plastic device placed inside the shoe to support the arch area while walking. AlthoughAlthough it does not cure flat feet, it helps relieve pain and makes walking easier.

**Specialized shoes:** Your doctor may recommend special shoes to provide support to the arch area and reduce pressure on it, or use heel cups (molds to support the heel).

**Physical treatment for flat feet**

**Stretching exercises:** Such as the heel stretch exercise that lasts for 30 seconds, with the exercise repeated four times for each leg.

**Golf ball exercise:** The child sits on a chair and rolls a golf ball or tennis ball using the sole of his foot, focusing on the lower part of the arch of the foot for two to three minutes, then repeats the exercise with the other foot.

**Arch lift exercise:** This exercise helps strengthen the muscles responsible for forming the arch of the foot, and should be repeated 10 to 15 times in two or three sets.

Trunk strengthening exercises to enhance stability.

**Heel lift exercise:** This exercise is effective for strengthening the leg muscles. This is done by standing and raising the heels as high as possible for 5 seconds, then repeating this movement 10 to 20 times in two or three sets.

**Heel exercises:**

The Achilles tendon stretching exercise enhances the flexibility of the tendon and the back muscles of the leg.

To do this exercise, stand facing a wall and place one hand on it at eye level. Then place the leg that needs stretching approximately one step behind the other leg, with the heel fixed on the floor. Then, bend the knee of the front leg until you feel a stretch in the back leg.

Stay in this position for 30 seconds, then rest for 30 seconds. Repeat this process nine more times.

It is important to avoid arching the back and keep it straight while performing the exercise.

Foot gymnastics includes lifting or carrying marbles using the toes, arranging objects using the toes, or writing numbers in the sand using the big toe. These exercises aim to strengthen the muscles of the foot.

Downward Dog is a yoga pose that aims to strengthen and lengthen the calf muscles and Achilles tendon.