A common condition that presents to podiatry are flat feet. People often get concerned about the appearance and effects of their fallen arches. Flat feet occur when our arch and ankle joints excessively roll in, flatten or pronate.
Pronation in the foot is normal and necessary for shock absorption and reducing strain going through our lower limbs when walking. However if this rolling in is excessive, if there is any pain in the feet, ankles, knees, hips or lower back that may be attributed to the foot type then this may need to be corrected.
Types of Flat Fleet
There are two different types of fallen arches, these include flexible flat feet and rigid flat feet.
Flexible:
- Occurs when there is a visible arch when sitting, and this arch becomes flatter when standing.
- Raising upon the toes would show an arch difference compared to standing.
- We would also look at the range of motion in the joints, which typically would be more flexible and loose compared to a rigid flat foot.
- Flexible flat feet are associated with less tissue stress as they are adaptable.
Rigid:
- Occurs when the same arch height, or lack of, is present in the chair and also when weight bearing.
- Raising onto the toes shows minimal, or if any, difference in arch height.
- Legs tend to be more bowed.
- Limited range of motion in the foot and ankle joints.
- Rigid feet are less flexible, less adaptable and associated with larger tissue stress.
Out of the two different types of flat feet, we would be more inclined to treat the rigid flat foot as the tissues surrounding these joints are under a larger amount of strain and also associated with lower limb pain. If necessary we also treat the rigid flat foot without pain to minimise overuse in the feet that can lead to conditions such as osteo- arthritis. We would treat a flexible flat foot, if associated with pain in the feet, ankles, knees, hips and lower back. However in the absence of pain flexible flat feet do not normally need to be corrected.
Assessment of Flat Feet:
- Assessing the ankles, knees and hips and their range of motion and if this is attributed to the fallen arches.
- Testing the strength of the muscles in the legs and feet.
- Undertaking a range of functional test to determine if your feet are working properly.
- Checking the wear patterns on your footwear and watching you walk barefoot and in shoes.
- Sending for diagnostic imagine ultrasound, CT, MRI or X-ray if necessary.
Treatment of Flat Feet:
Treatment may include a combination of the following treatments.
- Strengthening activities to support the arch muscles.
- Footwear assessment, prescription and recommendations.
- Foot orthotics to help realign the lower limb and offload any tissue strain.
- Foot mobilisation and manipulation therapy to restore movement and flexibility within the joints.
- Tool Assisted Massage and/ or dry needling to release the muscles int he legs and feet to improve mobility.
- Shockwave therapy to assist with pain and healing in the foot if necessary.
If you have noticed your arches have collapse or if you are experiencing any pain in the feet, ankles, knees, hips and lower back we would suggest a podiatry visit to help determine the cause of the flat feet and discuss treatment required.
