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Flat feet/fallen arches

Having flat feet is also known as having fallen arches, and means the arches of the feet are low or there are no arches.

Flat feet may not cause any pain or problems, but strain can be caused to muscles and ligaments making it painful when walking.

Test yourself for flat feet

You can easily test yourself to see if you might have fallen arches or flat feet. Follow these three steps:

  • Get your feet wet.
  • Stand on a flat surface where your footprint will show, such as on grey concrete pavement.
  • Step away and look at the prints. If you see complete imprints of the bottom of your feet on the surface, then you're likely to have flat feet.

Many young children have flat feet, a condition referred to as flexible flat feet. When the child stands, the feet look flat. However, when the child rises to his or her toes, a slight arch appears. In most cases, as children grow older, the arches develop.

Causes of flat feet and fallen arches

Flat feet in adults can arise from a variety of causes. Here are the most common:

  • An abnormality that is present from birth
  • Stretched or torn tendons
  • Damage or inflammation of the posterior tibial tendon (PTT), which connects from your lower leg, along your ankle and to the middle of the arch
  • Broken or dislocated bones
  • Some health conditions such as rheumatoid arthritis
  • Nerve problems

Other factors that can increase your risk include:

  • Obesity
  • Diabetes
  • Ageing
  • Pregnancy

Symptoms of flat feet and fallen arches

Many people have flat feet - and notice no problems and require no treatment. However, others may experience the following symptoms:

  • Feet tire easily
  • Painful or achy feet, especially in the areas of the arches and heels
  • The inside bottom of your feet becomes swollen
  • Foot movement such as standing on your toes is difficult
  • Back and leg pain

If you notice any of these symptoms it's time to seek medical advice.

Diagnosing flat feet and fallen arches

Your doctor or podiatrist examines your feet to determine two things:

  • Whether you have flat feet
  • The cause(s)

An examination may include these steps:

  • Checking your health history for evidence of illnesses or injuries that could be linked to flat feet or fallen arches
  • Looking at the soles of your shoes for unusual wear patterns
  • Observing your feet and legs as you stand and do simple movements such as raising up on your toes
  • Testing the strength of your muscles and tendons, including other tendons in the feet and legs such as the Achilles tendon or the posterior tibial tendon
  • Taking X-rays or an MRI of your feet

Treatment for flat feet and fallen arches

Treatment for flat feet and fallen arches depends on the severity and cause of the problem. If flat feet cause no pain or other difficulties, then treatment is probably not needed. In other cases, your doctor may suggest one or more of these treatments:

  • Rest and ice to relieve pain and reduce swelling
  • Stretching exercises
  • Pain relief medications such as nonsteroidal anti-inflammatories
  • Physiotherapy
  • Orthotic devices, shoe modifications, braces or casts
  • Injected medications, such as corticosteroids, to reduce inflammation

If pain or foot damage is severe, your doctor may recommend surgery. Procedures may include the following:

  • Fusing foot or ankle bones together (arthrodesis)
  • Removing bones or bony growths - also called spurs (excision)
  • Cutting or changing the shape of the bone (osteotomy)
  • Cleaning the tendons' protective coverings (synovectomy)
  • Adding tendon from other parts of your body to tendons in your foot to help balance the "pull" of the tendons and form an arch (tendon transfer)
  • Grafting bone to your foot to make the arch rise more naturally (lateral column lengthening)
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