Ethyl Sabine

Solving Foot Ailments

Fallen Arches What To Expect

Overview

Flat Feet

If you look at an adult foot from the inside, you'll usually notice an upward curve in the middle. This is called an arch. Tendons, tight bands that attach at the heel and foot bones form the arch. Several tendons in your foot and lower leg work together to form the arches in your foot. When the tendons all pull the proper amount, then your foot forms a moderate, normal arch. When tendons do not pull together properly, there is little or no arch. This is called flat foot or fallen arch.

Causes

Fallen arches have many causes. If you have fallen arches, or flat feet, the normal arch in the middle of your foot is not curved properly. You can have this condition called ples planus in medical terms and never have any symptoms. However, fallen arches can lead to foot pain, fatigue or more serious conditions. If fallen arches alter the way you walk, you may eventually develop knee, hip and low back pain. Your foot may lose normal range of motion making it hard to rise up onto your toes. In some cases, your feet can become swollen. If you have this condition, talk to your doctor about an appropriate treatment plan.

Symptoms

A significant number of people with fallen arches (flat feet) experience no pain and have no problems. Some, however, may experience pain in their feet, especially when the connecting ligaments and muscles are strained. The leg joints may also be affected, resulting in pain. If the ankles turn inwards because of flat feet the most likely affected areas will be the feet, ankles and knees. Some people have flat feet because of a developmental fault during childhood, while others may find that the problem develops as they age, or after a pregnancy. There are some simple devices which may prevent the complications of flat feet.

Diagnosis

Determining whether you have fallen arches may be as easy as looking at the shape of the middle bottom of your foot. Is there any kind of arch there? If you cannot find any kind of arch, you may have a flat foot. There are, however, other ways to decide in case you're still not sure. Another way to figure out if you have flat feet is to look at a few pairs of your shoes. Where do you see the most wear on the heels? If you notice significant wear in the heel and the ball of the foot extending to the big toe, this means you are overpronating. Overpronators roll their feet too far inward and commonly have fallen arches. To figure out if you have flat feet, you can also do an easy test. Get the bottoms of your feet wet and then step on to a piece of paper carefully. Step off the paper and take a look at the print your foot made. If your print looks like the entire bottom of a foot, your feet are flat. People with an arch will be missing part of the foot on their print since the arch is elevated off of the paper. Regular visits to your podiatrist are highly recommended.

fallen arches exercises

Non Surgical Treatment

If you have flat feet you may not necessarily need treatment -- sometimes a child or even an adult will have low arches and have no problems. It's normal for a baby's or young child's feet to appear flat until the structure of their feet is more fully developed. If flat feet are contributing to secondary problems, especially leg or foot pain, treatment may be necessary. Flat feet can sometimes cause difficulty walking or running and interfere with athletic activities. A visit to a podiatrist will involve an evaluation of foot structure and function. Besides a foot exam, a visit may include foot X-rays and an analysis of your feet while walking. Your podiatrist may prescribe arch supports or orthotics to control the pronation. While orthotics and arch supports don't permanently correct the shape of the arch, they do help control excess pronation that may be causing wear-and-tear on your muscles and joints. Sneakers with a design called motion control are also helpful for overpronators. This style of sneaker has a design that creates more stability by limiting movement in the heel and arch area of the shoe. Additionally, physical therapy and stretching exercises may be in order, especially if tendonitis (tendon inflammation) is present. Flat feet that are the result of congenital or developmental abnormalities may require further intervention, such as bracing, casting or surgical correction. A brace incorporates an arch support into a device that attaches to the lower leg, giving extra support and flat-foot control. Bracing or foot surgery may also be warranted in cases when flat feet are caused by neurological diseases or are aggravated by posterior tibial tendonitis, which can be a long-term complication of flat feet. Casting is a method used for children whose flat feet are caused by bone positional abnormalities, such as metatarsus adductus. It involves using a series of casts to assist in re-aligning leg and foot bones to their proper anatomical position.

Surgical Treatment

Adult Acquired Flat Feet

In cases of flat feet that have progressed substantially or have failed to improve with non-surgical treatment, surgery may be required and in some advanced cases, surgery may be the only option. Your foot and ankle surgeon will determine the best approach for you.

Prevention

Donning a first-rate pair of arch supports, therapeutic socks and proper footwear before heading out to enjoy hours of holiday fun is one option to consider. Your podiatrist can help you find just the right ones. Once you have them on, they?ll help ease the amount of pressure being put on your body and keep the blood flowing in the right direction. While you?re standing in line, consider doing a bit of exercise as well. We?re not talking about channeling your inner Jack LaLanne here. Otherwise, you might attract the attention of the mall security guards. Simple ankle rotations and walking in place may help to reduce edema and give your flat feet a bit of a break. If you happen to be in a shopping mall or center where foot massages are available, take advantage of them periodically. They are likely to make you feel better and it?s a great excuse to carve out a few quiet moments for yourself. If you can?t visit a professional, tuck a personal foot massager into your purse. That way, you can lightly massage your own feet during the car ride home. Lastly, there are certain foods and nutritional supplements available that may reduce edema caused by standing on flat feet for hours at a time. The list includes potassium rich foods like raisins, bananas, baby carrots, nuts and yogurt. So, you may want to pack a snack for those trips to the mall or hit the food court before you hit the stores.

After Care

Patients may go home the day of surgery or they may require an overnight hospital stay. The leg will be placed in a splint or cast and should be kept elevated for the first two weeks. At that point, sutures are removed. A new cast or a removable boot is then placed. It is important that patients do not put any weight on the corrected foot for six to eight weeks following the operation. Patients may begin bearing weight at eight weeks and usually progress to full weightbearing by 10 to 12 weeks. For some patients, weightbearing requires additional time. After 12 weeks, patients commonly can transition to wearing a shoe. Inserts and ankle braces are often used. Physical therapy may be recommended. There are complications that relate to surgery in general. These include the risks associated with anesthesia, infection, damage to nerves and blood vessels, and bleeding or blood clots. Complications following flatfoot surgery may include wound breakdown or nonunion (incomplete healing of the bones). These complications often can be prevented with proper wound care and rehabilitation. Occasionally, patients may notice some discomfort due to prominent hardware. Removal of hardware can be done at a later time if this is an issue. The overall complication rates for flatfoot surgery are low.