The flat foot is a common disorder. Up to 20 percent of adults have flat feet. Considering the frequency with which we encounter the flat foot, understanding about flat feet is poor.
As is most people know, a flat foot is characterised by loss of the arch. This is but one of the features needed to make a diagnosis of a flat foot. Using this criteria alone would leave many people with normal feet with normal feet labelled as having flat feet. Other features to confirm the diagnosis include:
- Hindfoot valgus (heel pointing outwards)
- Forefoot abduction ( front of the foot pointing outwards)
“In patients who present late, joints in the foot have to be fused in order to correct the severe deformity.”
As the degeneration worsens, the tendon stretches out more, resulting is a progressively flatter foot. Pain from this condition results from multiple sources:
- Pain from tendon degeneration and inflammation
- As the arch collapses, bones begin to abut and rub against each other, resulting in pain
- Arthritis from the abnormal loading of joints with increasing deformity
As with all ailments, there is a spectrum of severity when a patient with this condition presents for medical attention. In the early stages of this disorder, a patient is usually put in a cast to rest the damaged tendon. Failing this, a surgical procedure to remove inflamed tissue and a repair of the damaged area of the tendon is performed. As the disorder becomes more advanced, surgery is performed to adjust the position of the bones in the foot, to correct the deformity. At the same time, other tendons are recruited to augment the function of the damaged posterior tibial tendon, in order to maintain the arch. In patients who present late, joints in the foot have to be fused (made stiff and rigid) in order to correct the severe deformity.
It is important to recognise this disorder early as severity worsens with time. Early treatment is less invasive and is associated with better outcomes than treatment of the disorder in its advanced stages.
Most people with flat feet are able to lead an active lifestyle without more foot dysfunction than a person with normal arches. Pain from flat feet can be treated. Do seek professional help if you have painful flat feet, particularly if it is associated with a worsening or a new deformity.
Dos for flat feet
- Lead a healthy, active lifestyle if you have a painless, long standing flat foot
- Seek advice before buying sports shoes – especially for running
Don’ts for flat feet
- Ignore a foot which is getting flatter in adulthood
- Neglect a painful flat foot – something can be done to help you