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Q: What causes flat feet? Is it a common condition?
A: Flat feet are a common condition, estimated to occur in approximately 20 to 30 percent of the population. There are many reasons why an individual may have a flat-foot condition.
First, there may be a rare congenital defect, which is present at birth, such as vertical talus, which manifests as a rigid rocker-bottom flat foot. But, generally, most infants and toddlers do have flat feet because the arch structure has not yet developed. The development of the arch normally occurs during early childhood after 3 years of age.
In the 10- to 14-year-old range, a cause may be a condition called tarsal coalition. This is an abnormal connection between two bones in the foot which leads to a painful, spasticity (stiffness) of the peroneal tendon.
As we age, there are many reasons why an individual may develop a flattening of the arch, which is known as an acquired flat foot. These causes are developmental and include:
- Connective tissue disorders, such as rheumatoid arthritis.
- Endocrine disorders such as diabetes mellitus.
- Osteoarthritis.
- Tight Achilles tendon.
- Dysfunction of the posterior tibial tendon; when the tendon on the inside of the ankle loses its functionality.
- Obesity.
- Aging.
- Trauma.
Finally, the hereditary or genetic predisposition to a flat foot is also a possible cause.
Q: What symptoms might someone with flat feet experience?
A: Symptoms are varied and depend upon the cause of the flat foot, the individual’s activity level and the type of footwear that is worn. An individual may present to the office with heel or arch pain (plantar fasciitis), Achilles tendinitis, pain in the subtalar joint or ankle discomfort. Patients will often have several symptomatic areas, have difficulty with exercise, and may even have knee, hip or back pain.
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Q: When should someone with flat feet see a Podiatrist?
A: Typically a patient will not seek professional treatment unless they are symptomatic, except for those times when a parent may be concerned with their child’s foot structure or function. The question arises: If someone has a flat foot will they be symptomatic or develop problems later in life? The answer to this is, not everyone will develop issues later on. With that being said, medical treatment should be sought if one is symptomatic with pain or if the flat foot condition is severe (a significant rolling inward of the foot and ankle during walking).
Additionally, if one has noticed a change in their foot structure such as a sudden collapse of the arch or has a medical condition with decreased sensation
to their feet (such as in diabetes mellitus), there are sufficient studies that show the initial evaluation and periodic follow-ups with a podiatrist may help
prevent further complications.
Q: What are some easy solutions that people can try?
A: Wearing well structured shoes and sandals that provide adequate support to the arch structure of the foot. It is important to understand that one size does not fit all. Some flat foot cases may require custom-made orthotics, an ankle/foot brace, special shoes and in extreme cases, surgery.
Q: When is surgery necessary for flat feet?
A: Surgery is an alternative when conservative measures have not provided a satisfactory relief from pain and discomfort. Additionally, patients who are at risk for chronic breakdown or ulcerations on the bottom of their feet due to the complete loss of the arch structure are good candidates for surgical intervention to prevent further complications. For the most part, however, conservative and non-surgical treatment plans will be effective in the majority of cases.
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