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Flat Foot

In case of adults, when one stands on two feet with body weight supported evenly on them, there is an arch created just in the middle of the foot. However, the depth of space under the arch can be variable. On the other hand, in case of young children their feet might often look a little flat with little or no space between the foot and the floor. This is usually normal as the arch tends to develop in their feet by 9 or 10 years of age. Here is everything you need to know about swollen feet. Tendons in the heels and bones in the feet while working in sync with your lower legs form this so-called arch in your feet. If the tendons pull the bones adequately, then the arch is formed, else the feet are flat with little or no arch at all. This is called the flat feet syndrome.

Cause

Here are a few reasons that could lead to flat feet syndrome:
Tarsal coalition: This is a condition that develops during early childhood wherein an abnormal fusing of some foot bones makes the foot stiffer and quite flat. Tibialis posterior or tendon dysfunction: In this condition a large ankle tendon can degenerate causing it to stretch and cease working correctly. It can be an unexplained condition in many patients, in others it can be due to minor injuries.
Overweight: Excessive laxity in the joints due to sudden weight gain could also be a possible cause. Here are 12 shocking reasons why you are putting on weight.
Arthritis: Especially if it occurs in the back or middle of the foot, it could be really painful. It can be caused by an injury or develop with no real explanation and lead to flat feet.

Should you worry if you have flat feet?

In many people, if flat feet have been present since teenage years it may simply be the way their foot is shaped and entirely normal. In these cases both feet are often the same. There are many so-called foot specialists who might point out that these people suffer from fallen arches or flat feet. However, one should be very cautious and get checked by a specialist before acting on such advices. Having a longstanding flat foot can be perfectly normal.

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Symptoms

Here are some symptoms of flat feet:

  • Pain during walking, especially along the inner border of the feet and ankle.
  • Difficulty in running due to pain.
  • Swelling on the insides of the ankle.
  • Tingling or numbness on the insides or sole of the foot because of nerves being stretched or compressed.

When should one worry about flat feet?

If you notice that only one foot is affected or has fallen flat as compared to the other, it may be an abnormal condition and need medical attention. If your foot shape changes over time, i.e., if you had normal arches and then the foot flattens then there is likely an abnormality. If you develop such abnormality, there are chances that you might experience pain in that particular foot often. People complain of discomfort in the affected foot after exercise or excessive wear and tear. However, in some rare cases, one might have quite a stiff foot since childhood, which during adulthood can become increasingly painful. This could be an abnormally flat foot.

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Diagnosis

The diagnosis is based on an accurate history or by taking a detailed account of symptoms from the patient. Examining the foot for pain and swelling can differentiate a normal and abnormal flat foot. X-rays can display the overall shape of the flat foot. They can also diagnose arthritis as a feature of the flat foot. An MRI scan is useful to determine whether the tendon is working normally and also if there are any abnormal bony fusions.

What are the different stages of flat feet?

Problems related to flat feet are classified into different stages and these stages define what sort of treatment can be carried out to solve the problem.
Stage one: In this stage there is inflammation of the tendon but no obvious deformity. Diagnosis is made during a physical examination and confirmed by ultrasound or MRI.
Stage two: The severity of the flat foot is increasingly evident in this stage. However, the foot doesn’t appear to be stiff or arthritic.
Stage three: The condition becomes increasingly painful as it reaches to this stage and might have led to stiffness and arthritis in the hind foot.
Stage four: This stage indicates that you need help to get back on your feet. The arthritis would have spread to the ankle joint and this could make it painful and unbearable at times.

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Treatment

There are both non-surgical and surgical options to treat flat foot syndrome.

The non-surgical options: If the affected foot is flat but flexible then it can be treated with simple insoles and physiotherapy. The idea is to support the foot to stop it from getting worse. But unfortunately the arch would be permanently flat without the insoles. For a more active person like an athlete this treatment may not be satisfactory. In this case, surgery to re-create the arch can be performed to correct the condition. Here is how physiotherapy works to relieve your symptoms.

The surgical options: Surgery is sometimes required if the condition is more severe. The following procedures may be considered:

The calcaneal osteotomy: Sometimes known as the ‘heel shift’, this procedure involves moving the calcaneam, the large bone at the back of the heel which is out of alignment, re- positioning it and then securing the bone using screws. This procedure can at times be done in a minimally invasive way.

A tendon transfer: This is considered if the tibialis posterior tendon is severely damaged. A tendon is taken from one of the lesser toes, which is then transferred to run behind the medial malleolus. This does not affect the function of the toes and patients make a full recovery.

Fusion: At the final stages (stage 3 and stage 4) of adult flat foot, the fusion of joints needs to be considered in order to effectively eliminate pain.

When should you go under the knife to treat flat feet?

Many patients are simply seeking advice on managing a problem. If you have an abnormal flat foot, it will never be solved without surgery. You can manage it with special insoles and physiotherapy but it can still get worse. Specially made shoes can be an attractive option, if your lifestyle is less active than others. Surgery is successful in over 80% of patients and is worth discussing with your surgeon.

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Home Remedies

In the case of adults there are some home remedies you can try.

  • If you have severe pain, try soaking your feet in a bucket of warm water with salt and ajwain. This will help reduce the pain and inflammation.
  • Avoid wearing high heels and modify the shoes you wear to suit your feet.
  • Finally, visiting a physiotherapist to learn exercises that can strengthen the tendons of your feet, is a good idea.

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