What are flat feet?

Causes and Symptoms

Congenital flat feet
are considered to be hereditary. Acquired flat feet can be caused by stretching of the arch ligaments and a weakness of the muscles found in the arches; this produces flexible flat feet. Rigid flat feet are caused by changes in the shape of the foot bones or a short Achilles tendon. Other causes of flat feet include injury and a lack of muscle tone or weak foot muscles that cannot sustain the body’s weight.

All infants appear to be flat-footed because of a pad of fat under each instep. Arch formation in the feet takes place once they begin walking. Flat feet are often detected by parents when an infant experiences delays in learning how to walk.

Flat feet usually are painless and do not contribute to changes in posture or the ability to walk. Adolescents and adults are occasionally prone to fallen arches, or temporary foot strain caused by an activity that overstretches the ligaments in the arch; this condition is accompanied by pain. Rigid flat feet caused by a short Achilles tendon and spastic flat feet caused by a deformity of the heel result in pain and clumsiness in walking.

Treatment and Therapy

Flexible, pain-free flat feet require no treatment. Special orthopedic shoes with arch supports do not change the shape of the feet over time, while foot exercises and prescribed changes in gait are hard to enforce in children.

In cases of fallen arches accompanied by fatigue or pain, however, rest, foot exercises, and the use of arch supports are recommended. If the Achilles tendon is too short or tight, it can be stretched by placing the foot in a cast. Severe cases of flat feet require surgery that removes excess bone or reconstructs the soft tissue of the foot.

Bibliography:

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Frowen, Paul, et al., eds. Neale’s Disorders of the Foot. 8th ed. Edinburgh: Churchill Livingstone, 2010.

Lippert, Frederick G., and Sigvard T. Hansen. Foot and Ankle Disorders: Tricks of the Trade. New York: Thieme, 2003.

Ma, C. Benjamin, et al. "Flat Feet." MedlinePlus, Jan. 17, 2013.

"Pediatric Flatfoot." Foot Health Facts. American College of Foot and Ankle Surgeons, Mar. 31, 2010.

Polsdorfer, Ricker, and Michael Woods. "Flat Foot." Health Library, May 2, 2013.

Van De Graaff, Kent M. Human Anatomy. 6th ed. New York: McGraw-Hill, 2002.