Overview
Fallen arches, or flat feet as they are often referred to, are a structural deformity whereby the arch of the foot lags or collapses. It?s very common, can be painful or not, can lead to a string of other ailments, but it is easily corrected. It is not more common in sports people or people who are overweight, but you knew all that, right?
Causes
Over-pronation is a common biomechanical problem that occurs when the arches collapse while walking or standing. This condition hampers our natural walking pattern, causing an imbalance, and leading to wear and tear in other parts of the body with every step we take. Whether you suffer from over-pronation like most of the population, or you have a true flat foot, in both cases your poor walking pattern may contribute to a range of different complaints. As we age, poor aligment of the feet causes very common conditions such as heel pain or knee pain. Over-pronation has different causes. Obesity, pregnancy, age or repetitive pounding on a hard surface can weaken the arch, leading to over-pronation. Over-pronation is also very common with athletes, especially runners, who most of them nowadays use orthotics inside their shoes.
Symptoms
Arches can be seen as ?rolling downward? or collapsing when walking. Pain may present in lower back, hips or knees. Pain may be present on the bottom of the heels, within the arch, within the ankles or even the forefoot. Swelling can occur. Pain may occur in the anterior leg muscles.
Diagnosis
You can always give yourself the ?wet test? described above to see whether you have flat feet. Most people who do not notice their flat feet or have no pain associated with them do not think to see a foot doctor. Flat feet can lead to additional problems such as stiffness or pain, however, especially if the condition appears out of nowhere. If you think you may have flat feet, you should seek medical attention to ensure there are no additional issues to worry about. Your doctor will be able to diagnose you with a number of tests. For example, he or she may have you walk around, stand still, or stand on your tiptoes while you are being examined. Your doctor may also examine your foot?s shape and functionality. It?s important to let your foot doctor know about your medical and family history. In some cases, your doctor may order imaging tests such as x-rays or an MRI (magnetic resonance imaging) to determine a cause of your flat foot. If tarsal coalition is suspected in children, a CT scan is often ordered.
How do you get an arch in your foot?
Non Surgical Treatment
The treatment is simple for flat feet. We will carry out a biomechanical assessment and full history, often along side a Computerised Gait Scan to give us an idea of how the foot is compensating. Treatment will be to, control how the foot hits the ground, support the middle of the foot and prevent the arch collapsing, promote normal movement in the front of the foot. The ability to do this will be dictated by the movement within the foot to start with. Treatment for all the above problems are often combined with a physiotherapy session in order to help develop a stretching and strengthening program for the back of the legs and the pelvis in order to allow normal function when the orthoses have been prescribed. If you are born with flat feet you will not grow out of them - if you get orthoses, like glasses you will need them for the rest of your life if you want to correct the mechanics in your foot. In 95% of cases, orthoses will reduce symptoms by at least 85%. In the other 5% we will work with them to get them to this level.
Surgical Treatment
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).
After Care
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.
Fallen arches, or flat feet as they are often referred to, are a structural deformity whereby the arch of the foot lags or collapses. It?s very common, can be painful or not, can lead to a string of other ailments, but it is easily corrected. It is not more common in sports people or people who are overweight, but you knew all that, right?
Causes
Over-pronation is a common biomechanical problem that occurs when the arches collapse while walking or standing. This condition hampers our natural walking pattern, causing an imbalance, and leading to wear and tear in other parts of the body with every step we take. Whether you suffer from over-pronation like most of the population, or you have a true flat foot, in both cases your poor walking pattern may contribute to a range of different complaints. As we age, poor aligment of the feet causes very common conditions such as heel pain or knee pain. Over-pronation has different causes. Obesity, pregnancy, age or repetitive pounding on a hard surface can weaken the arch, leading to over-pronation. Over-pronation is also very common with athletes, especially runners, who most of them nowadays use orthotics inside their shoes.
Symptoms
Arches can be seen as ?rolling downward? or collapsing when walking. Pain may present in lower back, hips or knees. Pain may be present on the bottom of the heels, within the arch, within the ankles or even the forefoot. Swelling can occur. Pain may occur in the anterior leg muscles.
Diagnosis
You can always give yourself the ?wet test? described above to see whether you have flat feet. Most people who do not notice their flat feet or have no pain associated with them do not think to see a foot doctor. Flat feet can lead to additional problems such as stiffness or pain, however, especially if the condition appears out of nowhere. If you think you may have flat feet, you should seek medical attention to ensure there are no additional issues to worry about. Your doctor will be able to diagnose you with a number of tests. For example, he or she may have you walk around, stand still, or stand on your tiptoes while you are being examined. Your doctor may also examine your foot?s shape and functionality. It?s important to let your foot doctor know about your medical and family history. In some cases, your doctor may order imaging tests such as x-rays or an MRI (magnetic resonance imaging) to determine a cause of your flat foot. If tarsal coalition is suspected in children, a CT scan is often ordered.
How do you get an arch in your foot?
Non Surgical Treatment
The treatment is simple for flat feet. We will carry out a biomechanical assessment and full history, often along side a Computerised Gait Scan to give us an idea of how the foot is compensating. Treatment will be to, control how the foot hits the ground, support the middle of the foot and prevent the arch collapsing, promote normal movement in the front of the foot. The ability to do this will be dictated by the movement within the foot to start with. Treatment for all the above problems are often combined with a physiotherapy session in order to help develop a stretching and strengthening program for the back of the legs and the pelvis in order to allow normal function when the orthoses have been prescribed. If you are born with flat feet you will not grow out of them - if you get orthoses, like glasses you will need them for the rest of your life if you want to correct the mechanics in your foot. In 95% of cases, orthoses will reduce symptoms by at least 85%. In the other 5% we will work with them to get them to this level.
Surgical Treatment
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).
After Care
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.