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Flat Foot

(Pes Planus; Pes Planovalgus; Fallen Arches)

Definition

Feet usually have an arch on the inside portion of the foot. A flat foot is a foot that has lost or never developed this arch. It is often associated with the lower part of the legs being angled outwards

Most flat feet are flexible. This type rarely causes problems and usually do not require treatment. Rigid flat feet can cause problems and are best treated.

Normal Foot Arch

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Copyright © Nucleus Medical Media, Inc.

Causes    TOP

Infants and young children naturally have flat feet. The arch should develop over time. Sometimes, the arch does not develop. It is not always clear why this happens.

Flat feet may develop because of:

  • Ruptured or damaged tendon that supports the arch
  • Medical conditions that affect muscles or nerves in the foot
  • Degenerative changes in certain foot joints
  • Ligament damage in the foot

Risk Factors    TOP

Factors that increase your chance of flat feet include:

  • Family history
  • Diseases that cause muscle or nerve damage, such as peripheral neuropathy, diabetes, cerebral palsy, spina bifida, or muscular dystrophy
  • Foot injuries
  • Conditions of the feet that can injure foot tissue such as osteoarthritis
  • Conditions present at birth, such as excess laxity of joint capsules and ligaments, such as Ehlers-Danlos syndrome
  • Obesity

Symptoms    TOP

Flat feet may not cause any symptoms at all. Rigid flat feet may cause:

  • Pain
  • Calluses, blisters, or skin redness on the inner side of the foot
  • A stiff foot
  • Weakness or numbness of the foot
  • Rapid wearing out of shoes—worn shoes lean in toward each other
  • Difficulty or pain with activities like running—in the foot, knee or hip

Diagnosis    TOP

Your doctor will ask about your symptoms and medical history. A physical and foot exam will be done. Flat feet can be diagnosed by appearance. To determine if the foot is rigid, you may be asked to do some simple tasks.

Treatment    TOP

If the flat foot is rigid and causing problems, you will be referred to a foot specialist. Talk with your doctor about the best treatment plan for you. Options include the following:

Physical Therapy and Exercises

Physical therapy may relieve discomfort. You may be given a specific stretching and strength program. You may also have treatment to help manage the discomfort.

Exercises can help with the strength of the surrounding muscles. It may relieve some of the pressure in the foot.

Orthotics and Support

Orthotics are shoe inserts that support the foot. These inserts may help to reduce pain and disability in some people. In mild cases, a well-fitting pair of shoes with arch support may be all that is needed.

Flat feet caused by nerve or muscle disease may need special braces.

Surgery    TOP

Feet that do not respond to the treatments above may need surgery. The surgery will help to create a supportive arch.

Prevention    TOP

Well-fitted shoes with good arch support may help prevent flat feet. Maintaining a healthy weight may also lower wear and tear on the arches.

RESOURCES:

American Academy of Orthopaedic Surgeons
http://www.aaos.org
American College of Foot and Ankle Surgeons
http://www.foothealthfacts.org

CANADIAN RESOURCES:

Canadian Podiatric Medical Association
http://www.podiatrycanada.org
Nurses Entrepreneurial Foot Care Association of Canada
http://www.nefca.ca

References:

Adult acquired flatfoot. American Academy of Orthopedic Surgeons website. Available at:
...(Click grey area to select URL)
Updated December 2011. Accessed May 2, 2013.
Flat foot. UCSF Children’s Hospital website. Available at:
...(Click grey area to select URL)
Accessed May 2, 2013.
Pes planus. EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-us. Updated November 12, 2010. Accessed February 20, 2014.
11/19/2010 DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us: Rome K, Ashford R, Evans A. Non-surgical interventions for paediatric pes planus. Cochrane Database Syst Rev. 2010;(7):CD006311.
Last reviewed February 2014 by Michael Woods, MD
Last Updated: 3/18/2013