Your foot arch is your natural shock absorption system. Nature designed it so that when you put your body weight over your feet the shock is absorbed by this mechanism in order to alleviate the impact (and subsequent injuries) that would otherwise hit your feet, ankles, knees and hips. A flat foot is the most visible sign of overpronation, meaning that your arch collapses during the impact on the ground. As a consequence, your ankle twists inward and your knees overcompensates. Flat feet are a particular concern for runners, as during the running gait the arch is supposed to support on average 3 times their body weight.
There are many different causes of flat feet, which can be separated into two main categories. The first category, congenital flat foot, is a condition that one is born with or is predisposed to at birth. This type includes the completely asymptomatic, pediatric flexible flat foot-by far the most common form of congenital flat foot. Flexible means that an arch is present until weight is put on the foot, at which time the arch disappears. This foot type is a result of the fact that all people are born with different physical features. Some people have bigger noses than others, just as some people have flatter feet (of course, there is no known correlation between the two). Any alteration in the many building blocks of the foot can influence its shape. At the other end of the spectrum, yet within the same category of congenital flat foot, exist several rare, more severe forms of flat foot. These severe conditions include Vertical Talus, Congenital Calcaneal Valgus, and Tarsal Coalitions - all of which are more rigid (no arch with or without weight on the foot) and definitely symptomatic. Luckily, these are much less common, but can usually be identified by specialists at the time of presentation and treated appropriately. The second category, acquired flat foot, develops over time, rather than at birth. Many different factors can contribute to the development of flat feet. These include the types of shoes a child wears, a child's sitting or sleeping positions, compensation for other abnormalities further up the leg, or more severe factors such as rupture of ligaments or tendons in the foot. Very commonly, the reason for flat feet is that the foot is compensating for a tight Achilles tendon. If the Achilles tendon is tight, then it causes the foot to point down, or to plantarflex (as occurs when stepping on the accelerator of your car). Even minimal amounts of plantarflexion can simulate a longer leg on that particular side, assuming that the other foot is in the normal position. The body therefore tries to compensate by pronating, or flattening out the arch, thereby making up for the perceived extra length on the affected side.
Pain and stiffness of the medial arch or anywhere along the mid-portion of the foot. Associated discomfort within and near the ankle joint. The knees, hips, and lower back may be the primary source of discomfort. Feet may often feel tired and achy. Painful shin splints may develop with activity. Gait may be awkward.
Diagnosis of flat feet or fallen arches can be made by your health practitioner and is based on the following. Clinical assessment involving visual gait assessment, as well as biomechanical assessment. A detailed family and medical history. A pain history assessment determining the location of painful symptoms. Physical palpation of the feet and painful areas. Imaging such as MRI or x-ray can be used by your practitioner to assist in the diagnosis.
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Non Surgical Treatment
The typical treatment for pain from fallen arches is an arch insert. While many people experience dramatic pain relief from this, others continue to suffer from chronic achy feet despite the arch support. The problem with this approach is that it does not do anything to strengthen the weak ligaments that may be at the root of the problem and, thus, does not alleviate the chronic pain that people with this condition experience. Another standard practice of modern medicine is to use steroids or to prescribe anti-inflammatory medications. However, in the long run, these treatments do more damage than good. Cortisone shots and anti-inflammatory drugs have been shown to produce short-term pain benefit, but both result in long-term loss of function and even more chronic pain by actually inhibiting the healing process of soft tissues and accelerating cartilage degeneration. Plus, long-term use of these drugs can lead to other sources of chronic pain, allergies and leaky gut syndrome.
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).