Also known as pes planus, flat foot is a common foot condition that affects both males and females. In people with this condition, the arch of the foot will collapse or fall, leading to pain, discomfort and other issues such as overpronation. Adult acquired flat foot deformity or AAFD is not the same as flatfoot in children. In most cases, children will usually outgrow this condition on their own, even without any treatments or interventions. On the other hand, adult-acquired flatfoot deformity is a permanent condition. Treatment methods for adult acquired flatfoot are designed to alleviate the symptoms and not treat the condition.
Types of Flat Feet
There are two main types of flatfoot – rigid flatfoot and flexible flatfoot. Flexible flatfoot is more common than rigid flatfoot. People with flexible flatfoot have a normal arch when walking or standing. However, that arch disappears once the foot strikes the ground or encounters a hard surface. In short, the flexible flatfoot will only present when weight is exerted on the foot. On the other hand, rigid flatfoot will present whether there is weight exerted on the foot or not. Rigid flatfoot is not common in children, compared to flexible flatfoot. It’s also important to note that all children appear to have a flat foot until their arches develop around the age of 5 or 6.
Rigid flatfoot can be congenital or acquired. If it develops in adulthood, it’s known as adult acquired flatfoot deformity or AAFD. Adult acquired flatfoot is also known as posterior tibial tendon dysfunction. Any adult is at risk of developing adult acquired flatfoot. However, this condition tends to be more prevalent in women above the age of 40. Pregnancy is also one of the predisposing factors for this condition. Also, adults with certain medical conditions like obesity, rheumatoid arthritis and diabetes are at a higher risk. People born with flat feet might also develop adult acquired flatfoot at some point. You are also likely to develop this condition if it runs in your family.
Causes of Flat Feet
As noted above, flatfoot is either congenital or acquired in adulthood. Posterior tibial tendon dysfunction or PTTD is one of the most common causes of adult-acquired flatfoot. Just like its name suggests, PTTD affects the posterior tendon – one of the most important tendons in your foot. The posterior tendon supports the arch of your foot when you are standing, walking or doing any activity that exerts pressure on the arches. If this tendon becomes swollen or injured, it can cause the arches to collapse. Posterior tibial tendon dysfunction is one of the most common causes of AAFD overweight individuals, pregnant women and people with rheumatoid arthritis. Also, athletes in various sports like basketball or football may also damage their posterior tibial tendon, which will eventually lead to fallen arches and flat feet.
Adult acquired flatfoot can also be caused by tears or injuries to the ligaments of your foot. For instance, injuries to the back and middle of the foot can lead to adult-acquired flatfoot. Diabetes can also cause flatfoot, due to the weakened tendons and ligaments in the foot. For instance, diabetic neuropathy can damage the nerves in the legs and feet, which means the patient might not notice when their feet collapse. As a result, severe flattening might occur, before the person notices their feet have a problem. And if this issue is not addressed on time, the bones in the foot will break and disintegrate due to the collapsed arches, leading to severely deformed feet. At that point, surgery or prescription bracing might be the only available treatment options for the condition.
Symptoms and Diagnosis
Symptoms of AAFD will vary from one person to the other, depending on the underlying causes. If the condition is caused by PTTD or posterior tibial tendon dysfunction, you will experience pain from the calf where it starts to the inside of the foot where it ends. You might also experience some pain and inflammation around the ankle. Pain when standing or walking can also be a symptom of this condition. This pain usually gets worse when you engage in vigorous activities like running. Adult acquired flat foot can also cause pain in the hips, lower legs, lower back, knees, and arch of the foot. With time, the fallen arches can cause rolling of the ankle and foot. The heel might also be forced to tilt outwards. Flatfoot can also cause shin splints. An excessive heel wear pattern, especially in the inner side of the sole, might also be a sign of flat feet.
Flatfoot is normally diagnosed through physical examination. The physician will examine your arch when walking or standing. They might also conduct a gait analysis. You might also be requested to stand on your heels or tip-toes, to see whether your foot develops an arch. Your healthcare might also recommend or conduct some imaging tests like MRI, CT scan, ultrasound or X-rays, to determine the extent and nature of the deformity. If the diagnosis proves that you have flatfoot, the physician will then seek to identify its cause, and then recommend the most appropriate treatment plan.
Home Treatment for Flat Feet
Treatment for AAFD will depend on the cause, the symptoms as well as its extent. However, it’s important to note that you are not treating the condition itself but you are alleviating the symptoms caused by adult acquired flatfoot. Therefore, treatment methods are designed to prevent the heel from rolling inward, prevent further collapse of the arch and alleviate the pain caused by flatfoot. Some of the available home treatment methods for flatfeet include:
- Taking non-steroidal pain relief medication like ibuprofen, Tylenol, and aspirin. Depending on the severity of your symptoms, your physician might prescribe pain-relief medication to alleviate the symptoms and provide pain relief.
- Soaking the feet in warm water after prolonged periods of walking or standing
- Lifestyle changes such as shedding extra calories and reducing weight
- Eating a balanced diet that is free from sugars, simple starches, bad cholesterol, and fat. Avoiding such foods will minimize the risk of diabetes, arthritis and high blood pressure, which can cause or aggravate flatfoot problems.
Your physician might also recommend that you wear arch-support inserts or custom orthotics. These insoles can be either custom-made or purchased over the counter. However, custom-made inserts provide better support than the generic ones. Instead of wearing ordinary slippers, you should be wearing slippers with arch support.
Apart from wearing arch support shoes, and custom orthotics, you can also alleviate the pain and discomfort caused by fallen arches or flat feet using various foot strengthening exercises. First, make sure you warm up your body using some light or low-impact exercises like rowing and cycling. After that, you can perform exercises such as toe raises, toe curls, marble pickups, and sand walking. If you are experiencing pain due to fallen arches, you can alleviate it using exercises such as toe extension, Achilles stretch and golf ball roll, among others. Make sure you consult your physician first before you start exercising. Keep your ankles and feet healthy can help to prevent discomfort and ease existing pain while minimizing the chances of injury.
Preventing Flat Feet
Flat feet is usually a hereditary condition. And as you might probably know, hereditary conditions can not be prevented. The good news is that you can prevent this condition from worsening using various coping mechanisms. If you are experiencing any of the above symptoms of flat feet, you first need to find walking shoes, which can compensate for your foot’s abnormal structure. In such a situation, you have the option of ordering a custom-made pair of corrective shoes or use custom-made orthotic insoles. Purchasing custom-made insoles is the cheaper option between the two. Furthermore, you can use these insoles with any of your shoes. You can purchase insoles for your running, walking or work shoes. And in some instances, you might not even need custom-made insoles. You just need to purchase a pair of well-fitting shoes, which can compensate for your abnormal gait such as motion control shoes, stability shoes, or comfort shoes.
If you are experiencing any of the symptoms related to flat feet, you should see a podiatrist as soon as possible. Don’t wait until the symptoms escalate, as you might end up with permanent damage on your feet. A podiatrist will assess your condition and then recommend the most appropriate solution.