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Flat feet, sometimes referred to as pes planus, fallen arches or pronation of feet, describes feet that do not arch in the middle. This means that in standing the entire sole of the foot is touching the floor. Flat feet in toddlers and infants is normal. As children grow, the feet normally develop an arch. So that by the age of ten most children no longer have them. However, in some children this development does not happen. This is a normal variation in foot type.
When an adult develops flat feet it may occur because the muscles supporting the inner foot and arch have weakened. In other cases the spring ligament, which runs along the medial aspect of the foot loses some of its tension allowing the foot to flatten. Sudden weight gain, a nervous system injury or fusion of the bones forming the arch can also lead to the development of them.
The symptoms of flat feet can vary from person to person. Painless flat feet do not require treatment. In other cases them may cause pain in the feet, medial ankle, calf muscles, knees, hips and even lower back. Pain generally worsens with activity.
Assessment by your physiotherapist can help in deciding on the most appropriate way to treat your painful flat feet. Often a change to a more supportive running shoe may be enough to relieve symptoms. Off the shelf or custom made orthotics which are moulded to the contours of your foot, can also help in greatly reducing symptoms.
Many individuals with them often have extremely tight lateral calf and hamstring muscle. This tightness can cause increased pronation during the push off phase of running or walking. Physiotherapy treatment such as soft tissue release and dry needling can help ease this tightness and improve biomechanics during the push off phase. This in turn lessens the degree of pronation, and therefore reduces discomfort when walking and running. Regular stretching and foam rolling assists in maintaining flexibility through these tight muscles.
In addition to stretching and wearing insoles, specific strengthening exercises have been shown to ease symptoms associated with them. Strengthening of the small muscle of the foot that supports the arch can assist in preventing progression. Also, worsening of flat feet/fallen arches. Strengthening of muscles higher up the kinetic chain such as the medial quad, gluts and core can also help in easing discomfort. This is because improved overall core strength and stability, reduces loading and makes the individual more mechanically efficient when walking and running.
Gait assessment and adaption to your running technique is also important to look at, especially if the symptoms first presented with running.
Unfortunately, these treatments will not change the shape of the feet. They will however, prevent progression of and ease aches and pains associated with the condition.
If you have been experiencing symptoms associated with flat feet or would like advice on how best to manage your flat feet, contact us here. Our physiotherapists are all experienced in treating a wide range of conditions associated with flat feet.