Flat feet indicates that no arch is present and the underside of the foot lies completely flat on the ground. The true 'flat foot' is very rare. In fact, less than 5% of the population have flat feet with no arch present whatsoever. It is quite normal for small children to have flat feet, however the arch usually develops as they get older. If the arch hasn't developed yet by the age of 5 or 6 the child may need children's orthotics.
Inflammatory arthritis, such as rheumatoid arthritis, can cause a painful flatfoot. This type of arthritis attacks not only the cartilage in the joints, but also the ligaments that support the foot. Inflammatory arthritis not only causes pain, but also causes the foot to change shape and become flat. The arthritis can affect the back of the foot or the middle of foot, both of which can result in a fallen arch. An injury to the ligaments in the foot can cause the joints to fall out of alignment. The ligaments support the bones and prevent them from moving. If the ligaments are torn, the foot will become flat and painful. This more commonly occurs in the middle of the foot (Lisfranc injury), but can also occur in the back of the foot. In addition to ligament injuries, fractures and dislocations of the bones in the midfoot can also lead to a flatfoot deformity. People with diabetes or with a nerve problem that limits normal feeling in the feet, can have arch collapse. This type of arch collapse is typically more severe than that seen in patients with normal feeling in their feet. This is because patients do not feel pain as the arch collapses. In addition to the ligaments not holding the bones in place, the bones themselves can sometimes fracture and disintegrate, without the patient feeling any pain. This may result in a severely deformed foot that is very challenging to correct with surgery. Special shoes or braces are the best method for dealing with this problem.
The primary symptom of flatfeet is the absence of an arch upon standing. Additional signs of flatfeet include the following. Foot pain. Pain or weakness in the lower legs. Pain or swelling on the inside of the ankle. Uneven shoe wear. While most cases of flatfeet do not cause problems, complications can sometimes occur. Complications include the following, bunions and calluses, inability to walk or run normally, inflammation and pain in the bottom of the foot (plantar fasciitis), tendonitis in the Achilles heel and other ligaments, pain in the ankles, knees, and hips due to improper alignment, shin splints, stress fractures in the lower legs.
People who have flat feet without signs or symptoms that bother them do not generally have to see a doctor or podiatrist about them. However, if any of the following occur, you should see your GP or a podiatrist. The fallen arches (flat feet) have developed recently. You experience pain in your feet, ankles or lower limbs. Your unpleasant symptoms do not improve with supportive, well-fitted shoes. Either or both feet are becoming flatter. Your feet feel rigid (stiff). Your feet feel heavy and unwieldy. Most qualified health care professionals can diagnose flat feet just by watching the patient stand, walk and examining his/her feet. A doctor will also look at the patient's medical history. The feet will be observed from the front and back. The patient may be asked to stand on tip-toe while the doctor examines the shape and functioning of each foot. In some cases the physician may order an X-ray, CT (computed tomography) scan, or MRI (magnetic resonance imaging) scan.
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Non Surgical Treatment
In many cases of PTTD, treatment can begin with non-surgical approaches that may include orthotic devices or bracing. To give your arch the support it needs, your foot and ankle surgeon may provide you with an ankle brace or a custom orthotic device that fits into the shoe. Immobilization. Sometimes a short-leg cast or boot is worn to immobilize the foot and allow the tendon to heal, or you may need to completely avoid all weight-bearing for a while. Physical therapy. Ultrasound therapy and exercises may help rehabilitate the tendon and muscle following immobilization. Medications. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, help reduce the pain and inflammation. Shoe modifications. Your foot and ankle surgeon may advise changes to make with your shoes and may provide special inserts designed to improve arch support.
In cases of flat feet that have progressed substantially or have failed to improve with non-surgical treatment, surgery may be required and in some advanced cases, surgery may be the only option. Your foot and ankle surgeon will determine the best approach for you.
Time off work depends on the type of work as well as the surgical procedures performed. . A patient will be required to be non-weight bearing in a cast or splint and use crutches for four to twelve weeks. Usually a patient can return to work in one to two weeks if they are able to work while seated. If a person's job requires standing and walking, return to work may take several weeks. Complete recovery may take six months to a full year. Complications can occur as with all surgeries, but are minimized by strictly following your surgeon's post-operative instructions. The main complications include infection, bone that is slow to heal or does not heal, progression or reoccurrence of deformity, a stiff foot, and the need for further surgery. Many of the above complications can be avoided by only putting weight on the operative foot when allowed by your surgeon.