How do I know if I have flat feet?

When a person stands, there should be a gap beneath the inner part of the foot, as the arch is raised off the ground.

If you stand on tip toes, do you see an arch of your feet? To confirm this further, you can push your big toe back as far as possible.

If an arch appears your foot is normal and flexible. If there is no arch, it means you have got flat feet. Sometimes you see a fallen arch in only one foot, but commonly you see Flat feet on both legs.

Flat feet are also called “Fallen arches”, which means you have no arch in your feet or the arch is very low. Therefore your feet will be flat on the ground.

The foot print of a person with Flat feet also differs from the foot print of a normal foot.

Our human foot is made out of 26 bones which are connected by 33 joints. There are more than 100 muscles, ligaments and tendons which make our feet flexible and prepare us to bear weight and mobilize. The arch provides a spring to your step and helps to distribute the body weight across feet to legs up to your hip.

If the arches are normal and flexible it is great. However if it is not, there are many ways you can overcome this issue. (Also be sure to check our selection of best running shoes for flat feet).

What are the causes for flat feet?

Common causes of Flat feet are;

• Genetics – Flat feet can pass from parents to their children through genes. If your father or mother suffers from Flat feet, it is likely that you inherited your Flat feet from them. There is a possibility that you pass it down to your children too.
• Injury to your foot or ankle – Trauma can cause damage to ligaments, joints or bones which can affect the alignment that may lead to flat foot. Overuse can damage ligaments and tendons and rupture them. Sometimes accidents may be the reason for injury leading to faulty foot alignment.
• Arthritis – If you have inflammation of your joints, it is called arthritis. There are many types of arthritis which affects the joints and surrounding connective tissues. Commonest type of arthritis is Osteoarthritis. However other rheumatic conditions like Rheumatoid arthritis, Gout and Fibromyalgia can also affect the joints and ligaments of the feet, giving rise to Flat feet. Sometimes tendinitis (inflammation of the tendons) can lead to flattened arch of the foot.
• Weak arch – If your arch is weak or over flexible, although there is a visible arch when you sit, foot will flatten onto ground once you stand.

When there is damage or rupture of your posterior tibial tendon, it can also lead to flat feet. This tendon plays a major role in supporting the arch of the foot.

• Nervous system or muscular diseases can lead to flat feet.
  Ex:
  1. Cerebral palsy – This is a disorder of movement, posture and muscle tone that is caused by damage which occurs to the developing brain before, during or up to few years after birth.
  2. Muscular Dystrophy – This is a genetic disorder which causes progressive weakness and loss of muscle mass due to degeneration of muscles.
  3. Spina bifida – A congenital defect in the spine, where the spinal cord is exposed through the gap of back bone, leading to paralysis of lower limbs.
• Tarsal coalition – In this condition, bones of your feet can unusually fuse together causing stiff and flat feet.
• Obesity – When you are overweight or obese, it can later result in Flat feet, as your feet become tensed bearing your excess weight down.
• Diabetes – Prolonged and uncontrolled diabetes can lead to many problems of your feet. This is called the “Diabetic Foot”. Flat feet are one of the complications of long term diabetes.
• Physiological conditions like pregnancy can lead to Flat feet due to changes in weight distribution. However this is reversible.
• Aging – Aging can weaken your posterior tibial tendon which plays a major role in maintaining the arch of your feet. When the arch becomes weak, the feet will flatten to ground.

What are the main symptoms of Flat feet and how do my symptoms relate?

Some people with flat feet do not experience any symptoms luckily. However others will experience a variety of symptoms, which depends on the severity of their Flat feet. As the structure of the arch determines how you walk, if it is not sturdy and flexible, you might experience symptoms related to your Flat feet.

• When standing, your feet can point outwards due to over pronation. When your feet are flat, they can roll to inner side when you stand and walk. If you look at your shoes carefully, the soles will have more wear and tear on inner sides.
• Pain and discomfort of the feet – This is the commonest symptom caused by Flat feet. Pain occurs due to strained muscles and ligaments in your Flat feet.
• Pain in your knees and hip – When the alignment is faulty, the weight distribution doesn’t occur well. This causes an abnormal stress on your knees and hip joints, causing pain and discomfort. There can also be pain in your calves, lower legs and lower back due to stress and poor weight distribution.
• Swelling of feet can occur and you may feel stiff especially after prolonged standing.

If you experience one or more of the above symptoms, it is likely that it is related to your Flat feet.

What are the problems and complications associated with Flat feet?

• Arthritis – Inflammation of joints can occur in people with Flat feet due to tension on joints. Arthritis can arise in your ankles, knees and hips secondary to flat feet.
• Tendonitis – Inflammation of tendons can occur such as Achilles tendinitis (Inflammation of the Achilles tendon) and Posterior tibial tendinitis (inflammation of Posterior tibial tendon).
• Plantar Fasciitis – Inflammation of ligaments in the soles of feet.
• Bunions – It is a bony bump that forms on the joint at the base of the big toe.
• Callus formation – These are thickened skin on the surface of soles which occur due to poor weight distribution.

Flat feet can affect your posture when you are standing. It can also affect your walking and running. When your body alignment is faulty, it can result in further injuries to your feet, ankles, knees and hips.

How do I overcome these issues related to my Flat feet? Possible treatment options

Flat feet needs treatment only if they cause discomfort or pain, if it indicates an underlying disorder or if it causes pain in other areas of the body.

When Flat feet causes problems to you, do not get disheartened, as there are always solutions for you. There are simple devices which you can use to support alignment of your feet or exercises you can follow to minimize your discomfort.

If you developed Flat feet recently, if you have pain and discomfort which doesn’t improve with well-fitting supportive shoes or if you have pain in knees, hip and back due to Flat feet, you should seek medical advice. Your doctor will diagnose the condition and will look for any underlying causes by ordering some investigations like X- Rays, CT or MRI scans.

If there are underlying causes like Arthritis, diabetes and other muscular conditions, they will be treated accordingly. Some with severe Flat feet may have to undergo surgery if necessary.

For the pain and inflammation, your doctor will prescribe anti-inflammatory pain killers like Ibuprofen or other NSAIDs depending on severity.

There are certain exercises recommended by the American Academy of Orthopedic Surgeons (AAOS) to improve the flexibility and strength of your feet. Get advice from a podiatrist or a physical therapist for specific exercises which can manage symptoms of Flat feet and prevent worsening of the condition.

Some of these exercises are;

• Heel cord stretching – This is to stretch the Achilles tendon and posterior calf muscles.
• Golf ball roll – placing a golf ball under your foot while being seated, roll it forward and back under the arch of foot. This stretches your plantar fascia ligament.

Get supportive well fitted shoes for flat feet. Fitted insoles or orthotics, or even custom designed arch supports can relieve pressure on your arch and reduce pain and discomfort of your feet and helps to distribute weight in a better way.

If there is inflammation of tendons, wearing an ankle brace may be helpful.

Rest until the symptoms subside is important if the Flat feet are due to a result of injury and inflammation.

Maintain a healthy weight. If you are obese, lose weight by following a proper diet plan and regular exercise.

Just because you have Flat feet, it doesn’t mean that you have to be worried over it. There are so many solutions to Flat feet. Meet your doctor, seek help. Learn an exercise routine. You will be able to lead a pain free life despite your Flat feet.

References:

https://www.medicalnewstoday.com/articles/168608.php
https://www.sciencedirect.com/science/article/pii/S0891842209000986?via%3Dihub
https://aaom.org/foot-problems/rheumatoid-arthritis-feet/
http://theshoesforme.com/flat-feet-everything-you-should-know/