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Pes Planus is the term used when an individual has flat feet, or fallen arches. This condition is such that the foot appears entirely flat on the floor on the inside.
Signs & symptoms
There are often no symptoms of a flat foot and so the individual rarely complains of problems in this area. It is more likely that they complain of other associated problems, including shin or calf pain, knee pain and back pain. Rigid flatfoot where the arch of the foot is very rigid, even when not weight bearing, may cause pain in the arch of the foot with stiffness. The feet may get tired easily and be tender. Low back pain is also common.
What are flat feet
Having flat feet is different to pronation, or overpronation. Pronation is a normal movement of the foot which occurs just after the heel touches the ground when walking. This means that the foot rolls inwards and arch lowers, to allow the foot to mould to the surface and to absorb shocks. Over-pronation is where too much pronation occurs, or it occurs too rapidly, which places additional stresses on the ankle, knee, hip and lower back.
A flat foot is usually evident from observing the foot, whereas someone who overpronate's may have a normal arch when standing still, which flattens excessively whilst walking or running.
The appearance of a flat foot is normal in infants, partially due to an increase in fat in this area, and also due to the arch not yet being fully developed. In teenagers and older people, however, it is less common and can cause problems.
Pes planus may develop from childhood or may only occur later in adult life. This is known as 'adult acquired flatfoot' and is usually due to an injury or prolonged stress to the foot. An example includes Posterior Tibial Tendon Dysfunction (PTTD) which is a dysfunction of one of the muscles which supports the arch of the foot.
Flat feet can be caused by genetic disorders, foot injury, obesity, rapid leg growth, too much exercise and traumatic injury to the arch of the foot.
Treatment for flat feet
If there is no pain caused by the flat feet then no immediate treatment is required. However, those who run or are involved in a lot of walking or being on their feet all day should ensure they have very supportive shoes or arch support insoles. This will help prevent any future injuries.
If pain is present, orthotic shoe inserts are useful, or special shoes can be commissioned. In severe cases where the flatfoot deformity is rigid, surgery may be performed, where some of the joints are fused together to create more of an arch. This should be considered a last resort.
Injuries caused by flat feet
Here are just a few injuries for which having flat feet is a common cause. Flat feet can also cause problems higher than this, for example in the knee, hip or even the lower back.