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What is flatfoot?
When the entire sole of the foot is in contact or near contact with the ground while standing, it is considered a flat foot. The result is that there is no arch to the foot. Flatfoot is a common disorder. It is a complex deformity, and there are types and stages that vary in degree of symptoms and disability. Flatfeet are also referred to as pes planus, posterior tibial tendon dysfunction, and fallen arches.
What are the different types of flatfoot?
There are two general types of flatfoot; flexible flatfoot and rigid flatfoot. If a person is sitting or standing on their toes and they have an arch that disappears when they stand with the entire foot on the ground they have a flexible flatfoot. If there is no arch, whether sitting or standing, they have a "rigid" or "true" flatfoot.
Flexible flatfoot is sometimes called "pediatric flatfoot" because it is first apparent in childhood. Congenital or rigid "true flatfoot" (talipes planovalgus) is much less common in children. Of note, almost all infants appear to have a flatfoot due to the fat pad on the sole of their feet and that the arch does not develop until 5 or 6 years of age.
When a rigid flatfoot develops in adults, it is called "adult acquired flatfoot" or "posterior tibial tendon dysfunction." This type of flatfoot develops because of the weakening of the tibialis posterior muscle tendon, which is a major supporting structure of the foot arch. It is a condition that leads to flattening of the arch and rolling in of the ankle. It is a progressive deformity with early symptoms of pain and swelling at the inside arch of the foot that progresses to the outside of the foot below the ankle. It eventually may lead to arthritis of the foot and ankle joints.
Flexible flatfoot is usually in both feet where posterior tibial tendon dysfunction or adult acquired flatfoot can occur in one or both feet.
Quick GuideCommon Causes of Foot Pain
What are other causes of flatfoot?
As described above, a person may be born with a flatfoot, pediatric flexible flatfoot, or develop it as an adult (adult acquired flatfoot). Less common causes of flatfoot include the following:
- Tarsal coalitions: A condition where joints bridge or grow together restricting or prohibiting movement of that joint.
- Accessory navicular bone (os tibiale externum): a small extra bone in the posterior tibial tendon that causes a weakening of support to the arch
- Ligament laxity in diseases such as Marfan syndrome or Ehlers-Danlos syndrome
- Charcot arthropathy
- Pregnancy, due to hormonal changes such as increases in elastin
What are flatfoot symptoms and signs?
A flatfoot may cause no symptoms. Symptoms of flatfoot include pain that may be in the inside arch, heel, or ankle and on the outside of the foot just below the ankle. Flattening of the arch can lead to rolling in of the foot and ankle and tilting outward of the heel. Flatfoot can also cause shin pain (shin splints), and aching of the knee, hip, and/or lower back.
How is flatfoot diagnosed?
One may look at their feet to see if they have an arch when standing barefoot for a general assessment. A foot specialist will provide an in-depth evaluation usually including X-rays to determine the precise type of flatfoot, its cause, and potential treatments.
What is the treatment for flatfoot?
It really depends on the type of flatfoot, its stage of progression, and the symptoms. Early treatment is advised whether one's condition is a flexible, rigid, or adult acquired flatfoot. Treatments include proper shoe gear, over-the-counter inserts, custom functional orthotics, bracing, casting, physical therapy, NSAIDs, weight loss, changes in activities, and surgery.
What is the prognosis of flatfoot?
This really depends on the type and severity of the flatfoot. Many people with pediatric or flexible flatfoot function without any signs or symptoms and are unrestricted in their levels of activity. These people do perfectly well without any treatments. Adult acquired flatfoot or true rigid flatfoot tends to be progressive, leading to functional disability and progression of symptoms that interfere with normal daily activities.
Medically reviewed by Aimee V. HachigianGould, MD; American Board of Orthopaedic Surgery
American College of Foot and Ankle Surgeons
American Podiatric Medical Association
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ArthritisArthritis is inflammation of one or more joints. When joints are inflamed they can develop stiffness, warmth, swelling, redness and pain. There are over 100 types of arthritis, including osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, lupus, gout, and pseudogout.
Childhood ObesityFast-food consumption and lack of exercise are just a couple of causes of childhood obesity. Health effects of childhood obesity include type 2 diabetes, heart attack, stroke, high cholesterol, asthma, sleep apnea, gallstones, fatty liver disease, GERD, depression, and eating disorders.
Ehlers-Danlos SyndromeEhlers-Danlos syndromes are genetic disorders that include symptoms such as loose joints, tissue weakness, easy bruising, and skin that stretches easily. There are seven types of Ehlers-Danlos syndromes: Classical type, Hypermobility type, Vascular type, Kyphoscoliosis type, Arthrochalsia type, Dermatosparaxis type, and Tenascin-X Deficient type. Treatment for Ehlers-Danlos syndromes depends on which symptoms are present.
Take the Feet Facts QuizDid you know that certain shoes and common diseases can wreak havoc on your feet? If you've been having problems with your feet, this quiz is for you.
Foot PainFoot pain may be caused by injuries (sprains, strains, bruises, and fractures), diseases (diabetes, Hansen disease, and gout), viruses, fungi, and bacteria (plantar warts and athlete's foot), or even ingrown toenails. Pain and tenderness may be accompanied by joint looseness, swelling, weakness, discoloration, and loss of function. Minor foot pain can usually be treated with rest, ice, compression, and elevation and OTC medications such as acetaminophen and ibuprofen. Severe pain should be treated by a medical professional.
Knee Pain FactsAcute injuries, medical conditions, and chronic use conditions are causes of knee pain. Symptoms and signs that accompany knee pain include redness, swelling, difficulty walking, and locking of the knee. To diagnose knee pain, a physician will perform a physical exam and also may order X-rays, arthrocentesis, blood tests, or a CT scan or MRI. Treatment of knee pain depends upon the cause of the pain.
Low Back PainThere are many causes of back pain. Pain in the low back can relate to the bony lumbar spine, discs between the vertebrae, ligaments around the spine and discs, spinal cord and nerves, muscles of the low back, internal organs of the pelvis and abdomen, and the skin covering the lumbar area.
Marfan syndrome is hereditary (genetic) condition affecting connective tissue. A person with Marfan syndrome may exhibit the following symptoms and characteristics:
- Dislocation of one or both lenses of the eye
- A protruding or indented breastbone
- Flat feet
- Aortic dilatation
- Dural ectasia (a problem with the sac surrounding the spinal cord)
- Stretch marks
- Collapsed lung
Though there is no cure for Marfan syndrome, there are treatments that can minimize and sometimes prevent some complications.
Obesity (Weight Loss)Obesity is the state of being well above one's normal weight. A person has traditionally been considered to be obese if they are more than 20% over their ideal weight. That ideal weight must take into account the person's height, age, sex, and build.
OsteoporosisLearn about osteoporosis, a condition characterized by the loss of bone density, which leads to an increased risk of bone fracture. Unless one experiences a fracture, a person may have osteoporosis for decades without knowing it. Treatment for osteoporosis may involve medications that stop bone loss and increase bone strength and bone formation, as well as quitting smoking, regular exercise, cutting back on alcohol intake, and eating a calcium- and vitamin D-rich balanced diet.
Signs and symptoms of pregnancy vary by stage (trimester). The earliest pregnancy symptom is typically a missed period, but others include
breast swelling and tenderness,
- nausea and sometimes vomiting,
- fatigue, and
Second trimester symptoms include
- weight gain,
- itching, and
- possible stretch marks.
Third trimester symptoms are
- additional weight gain,
- swelling of the ankles,
- fingers, and face,
- breast tenderness, and
- trouble sleeping.
Eating a healthy diet, getting a moderate amount of exercise, also are recommended for a healthy pregnancy. Information about the week by week growth of your baby in the womb are provided.
Shin SplintsShin splints result from inflammation from injury to the tendon and adjacent tissues in the front of the outer leg. Shin splints commonly occur in runners or aggressive walkers, causing pain and discomfort. An increase in workout intensity, weak ankles and pronation may be to blame for shin splints. Stretching, strengthening, and icing the affected area are effective treatments for shin splints. Rest and anti-inflammatory medications are also advised.
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