Flat feet (Pes Planus)

Flat feet & Claw foot

Pes Planus is the term used when an individual has very flat feet or fallen arches. This condition is such that the foot appears entirely flattened on the floor, with little or no arch.

Medically reviewed by Dr. Chaminda Goonetilleke, 20th Jan. 2022

Signs & symptoms

There are often no symptoms as such. So the individual rarely complains of problems. It is more likely that they complain of other associated problems which result from this foot type. These include:

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.

What are flat feet?

A flat foot is usually evident from observing the foot. 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.

Flat foot

Having flat feet is different from pronation and overpronation. Pronation is the normal movement of the foot which occurs just after the heel touches the ground when walking. The foot rolls inwards naturally and the arch lowers. This allows the foot to mold to the surface, and absorb shock.

Over-pronation is where too much pronation occurs, or it occurs too rapidly. This places additional stresses on the ankle, knee, hip and lower back.

What causes flat feet?

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 support 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 the 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.

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