Pronounced as "Pes Planus" in the medical realm, flat feet are a prevalent condition in society. A significant number of individuals experience this concern, and its severity can vary from mild to severe. The discomfort and pain associated with flat feet stem from a multitude of underlying causes.
Biomechanics
When examining flat feet, the analysis focuses on three "planes of deformity." Arches represent remarkably sturdy structures, as demonstrated by the enduring Colosseum in Greece. However, when the alignment or functionality of these arches is compromised, it disrupts the entire system. The arches play a crucial role in absorbing the impact as our feet make contact with the ground. Failure to adequately absorb this shock results in the redistribution of force to other parts of the foot, ultimately contributing to the development of arthritis. The misalignment of an arch can occur in three primary ways: vertically (sagittal plane), sideways (transverse plane), or through inward or outward rotation (frontal plane). Identifying which of these factors impact arch alignment is essential in addressing and improving foot function.
"Flat Feet" Vs. "Feet That Flatten Out"
When discussing flat feet while walking, it's crucial to recognize that certain individuals have feet that always lack an arch. This can result from congenital factors or a gradual loss of arches over time, leading to the foot becoming permanently flattened. If the arch returns when not bearing weight or can be manually corrected, it is termed "flexible." Conversely, if the foot remains flattened regardless of position, it's categorized as "rigid."
There are distinct considerations for "rigid" and "flexible" flat feet. In the case of flexible flat feet, there is usually room for improvement through adjustments in footwear, the use of orthotics, and similar measures. In contrast, rigid flat feet often require more intensive interventions, possibly including surgical procedures or, at the very least, specialized footwear.
How to Improve Function
Enhancing the functionality of flat feet is most effectively achieved through the utilization of arch supports, which effectively counteract over-pronation. It's important to clarify that by "arch supports," I'm referring to inserts./orthotics that possess a firm center, capable of providing substantial support to the foot. It's worth noting that these arch supports differ from the generic insoles commonly available at stores like Walmart.
To ensure optimal comfort, the introduction of a well-designed arch support should be gradual (wearing it for one hour the first day, two hours the second day, and so forth). This gradual approach helps mitigate any excessive discomfort to the arches of the foot as they adapt to the added support.
Tight Leg Muscles
A commonly observed issue related to flat feet revolves around a taut Achilles tendon. When the muscles in the leg are constricted, they apply an upward pulling force on the rear of the heel bone, subsequently causing the middle part of the foot (midfoot/arch) to shift downward. In order to raise the arch's height, introducing greater flexibility to the heel becomes imperative. When breaking in arch supports, stretching out the back leg muscles creates less downward force on the arch support during this period of time.
When Should You Be Concerned About Your Flat feet?
There are three primary regions of discomfort and potential arthritis that can flare up:
Lateral Ankle Pain: Pain experienced on the outside of the ankle.
Arch Area Pain: Discomfort occurring near the upper and inner portion of the arch.
Midfoot Pain: Pain felt on the outer underside of the midfoot.
Flat feet strain the posterior tibial tendon, leading to excessive work for this tendon to maintain the arch's elevation. Over time, the arch becomes increasingly dependent on this tendon, often resulting in a gradual reduction in arch height—a common occurrence. Another indicator of overworked tendons is pain in the arch when attempting to rise onto your toes on one foot.
The emergence of ankle pain is due to outward foot rotation, causing the lateral ankle to become pinched. Typically, this is a later stage in the progression of the problem.
Lastly, discomfort from the pinching of the outer bottom of the foot is caused by the heel bone exerting pressure on a bone called the cuboid. This prolonged pinching leads to arthritis and can result in significant pain over time.
If any of these three areas cause concern, it's advisable to seek assistance from someone knowledgeable in addressing this problem. Often, delaying treatment can result in increased foot rigidity and the onset of arthritis.
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