Flat
feet
(Pes
planus,
over-pronation,
Pes
planovalgus,
Fallen
arches,
Pronation
of
feet)
|
Definition
Pes
planus
is
a
condition
where
the
arch
or
instep
of
the
foot
collapses
and
comes
in
contact
with
the
ground.
In
some
individuals,
this
arch
never
develops.
Cause
Flat
feet
are
a
common
condition.
In
infants
and
toddlers,
the
longitudinal
arch
is
not
developed
and
flat
feet
are
normal.
The
arch
develops
in
childhood,
and
by
adulthood,
most
people
have
developed
normal
arches.
When
flat
feet
persist,
the
majority
are
considered
variations
of
normal.
Most
feet
are
flexible
and
an
arch
appears
when
the
person
stands
on
his
or
her
toes.
Stiff,
inflexible,
or
painful
flat
feet
may
be
associated
with
other
conditions
and
require
attention.
Painful
flat
feet
in
children
are
often
caused
by
a
condition
called
tarsal
coalition.
In
tarsal
coalition,
two
or
more
of
the
bones
in
the
foot
fuse
together
limiting
motion
and
often
leading
to
a
flat
foot.
Most
flat
feet
do
not
cause
pain
or
other
problems.
Flat
feet
may
be
associated
with
pronation,
a
leaning
inward
of
the
ankle
bones
toward
the
center
line.
Shoes
of
children
who
pronate,
when
placed
side
by
side,
will
lean
towards
each
other
(after
they
have
been
worn
long
enough
for
the
foot
position
to
remodel
their
shape).
Foot
pain,
ankle
pain,
or
lower
leg
pain
(especially
in
children)
may
be
a
result
of
flat
feet
and
should
be
evaluated
by
a
health
care
provider.
Symptoms
-
absence
of
longitudinal
arch
of
foot
when
standing
-
foot
pain
-
heel
tilts
away
from
the
midline
of
the
body
more
than
usual
Signs
and
Tests
Examination
of
the
foot
is
sufficient
for
the
health
care
provider
to
make
the
diagnosis
of
flat
foot.
However,
the
underlying
cause
must
be
determined.
If
an
arch
develops
when
the
patient
stands
on
their
toes,
then
the
flat
foot
is
called
flexible
and
no
treatment
or
further
work-up
is
necessary.
If
there
is
pain
associated
with
the
foot
or
if
the
arch
does
not
develop
with
toe-standing,
X-rays
are
necessary.
If
a
tarsal
coalition
is
suspected,
a
CT
scan
is
often
ordered.
If
a
posterior
tibial
tendon
injury
is
suspected,
your
health
care
provider
may
recommend
an
MRI.
Treatment
Flexible
flat
feet
that
are
painless
do
not
require
treatment.
If
pain
due
to
flexible
flat
feet
occurs,
an
orthotic
(arch
supporting
insert
in
the
shoe)
can
bring
relief.
With
the
increased
interest
in
running,
many
shoe
stores
carry
shoes
for
normal
feet
and
pronated
feet.
The
shoes
designed
for
pronated
feet
make
long
distance
running
easier
and
less
tiring
as
they
correct
for
the
positional
abnormality.
Rigid
or
painful
flat
feet
require
the
evaluation
of
a
health
care
provider.
The
exact
treatment
depends
on
the
cause
of
the
flat
feet.
For
tarsal
coalition,
treatment
starts
with
rest
and
possibly
casting.
If
this
fails
to
improve
the
pain,
surgery
may
be
necessary
to
either
resect
the
fused
bone
or
actually
completely
fuse
several
bones
in
a
corrected
position.
For
problems
with
the
posterior
tibial
tendon,
treatment
may
start
with
rest,
anti-inflammatory
medications,
and
shoe
inserts
or
ankle
braces.
In
more
advanced
cases,
surgery
may
be
necessary
to
clean
the
tendon,
repair
the
tendon,
or
actually
fuse
some
of
the
joints
of
the
foot
in
a
corrected
postion
in
very
advanced
cases.
Expectations
(prognosis)
Most
cases
of
flat
feet
are
painless
and
no
problems
are
to
be
expected.
The
prognosis
of
painful
flat
feet
again
depends
on
the
cause
of
the
condition.
Usually
treatment
is
succesful,
regardless
of
the
cause.
If
a
fusion
is
required
then
there
is
some
loss
of
ankle
motion,
especially
turning
the
foot
inward
and
outward,
but
otherwise
patients
with
fusions
report
tremendous
improvement
in
pain
and
function.
Complications
Flat
feet
are
not
really
associated
with
any
complications
except
pain.
Some
causes
of
flat
feet
can
be
successfully
treated
without
surgery
if
caught
early,
but
occasionally,
surgery
is
the
last
option
to
relieve
pain.
While
usually
successful,
surgery
sometimes
does
not
result
in
satisfactory
results
for
all
patients.
Some
have
persistant
pain
and
other
possible
surgical
complications
include
infection
and
failure
of
fused
bones
to
heal.
Prevention
Most
cases
are
not
preventable.
Recommendation
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Flexifly™
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Orthotics
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Silicone
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3/4
length
inserts
The
content
is
not
intended
to
be
a
substitute
for
professional
medical
advice,
diagnosis,
or
treatment.
Always
seek
the
advice
of
your
physician
with
any
questions
you
may
have
regarding
a
medical
condition.
This
site
does
not
provide
medical
advice.
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