This is the most common symptom. The pain typically occurs in the heel or arch area and may worsen with activity.
Flat Feet
Dr Kau Chung Yuan (许医生)
MBBS (S’PORE)
MRCS (Ireland)
MMed (Ortho)
FRCSEd (Ortho)
What is Flat Feet?
Flat feet, also known as fallen arches or pes planus, are a condition in which one or both feet have little to no arch, causing them to lie fully flat on the ground. This leads to the entire sole coming into complete or near-complete contact with the ground when standing. Typically, feet have an upward curve, the arch, primarily formed by tendons connecting the heel and foot bones.
Flat feet vary in severity and often cause no discomfort or hindrance in daily activities. However, for some, it may result in pain, particularly when standing or walking for long periods.
Causes
The causes of flat feet vary, encompassing both genetic factors and environmental influences.
- Genetic Factors
Some people are born with flat feet, indicating a hereditary component. - Ageing
The natural ageing process can weaken the tendons, resulting in flat feet. - Issues with Tendons and Connective Tissue
The tendons, particularly the posterior tibial tendon, play a crucial role in forming the arch. Dysfunction or damage to these tendons can lead to flat feet. Conditions that affect the body’s connective tissues can also result in collapsed arches. - Muscle Weakness or Damage
Weakness or injury in the foot and leg muscles can lead to flat feet. This may result from a direct injury or a condition such as cerebral palsy that affects muscle tone and control. - Obesity
Excessive body weight puts additional pressure on the tendons and ligaments in the foot, potentially leading to flat feet. - Foot Injuries
Trauma to the foot can damage bones, tendons, or ligaments, leading to the development of flat feet. - Medical Conditions
Certain medical conditions, such as rheumatoid arthritis or diabetes, can increase the risk of developing flat feet due to their impact on muscles and connective tissues.
Symptoms
The symptoms associated with flat feet can vary widely, depending on the person and the severity of the condition.
Pain in the Feet
Swelling
Swelling along the inside of the ankle can also be a sign of flat feet.
Pain in Other Parts of the Body
Flat feet can lead to alignment issues in the legs, which might result in pain in the knees, hips, or lower back.
Tired or Aching Feet
People with flat feet may experience general foot fatigue, especially after prolonged periods of standing or walking.
Difficulty in Foot Movement
Some people may have difficulty moving their feet, such as standing on their toes.
Changes in Gait
Flat feet can affect the way a person walks. The alteration in foot structure may cause the person to “roll” their feet inward while walking (overpronation).
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Diagnosis
The process of diagnosing flat feet involves a combination of physical examination and medical history evaluation. Here are the key steps typically involved in diagnosing flat feet:
- Physical Examination
A specialist will examine the feet from various angles. They may also observe the person walking or standing to assess the feet’s alignment and motion. - Medical History Review
The specialist will inquire about any symptoms experienced, their duration, and any known family history of flat feet or related conditions. - Footprint Analysis
This involves walking on a specialised mat that records the footprint. A flat foot typically shows a full imprint of the sole. - Imaging Tests
In some cases, further imaging tests like X-rays, CT scans, or MRIs may be recommended. These can help assess the flat foot’s severity and identify underlying conditions such as tendon damage or bone fractures. - Flexibility Tests
Testing the foot’s flexibility helps determine whether the flat feet are rigid or flexible. Flexible flat feet are less problematic and more responsive to non-surgical treatments.
Non-Surgical Treatment Options
Non-surgical treatment options for people with flat feet can effectively alleviate symptoms and improve foot function. The following are common non-surgical approaches:
Orthotic Devices
Custom-made or over-the-counter arch supports can help distribute pressure more evenly across your feet and provide additional support to the arches.
Supportive Footwear
Wearing shoes with good arch support and a cushioned sole is often recommended. Avoid wearing shoes that are too tight or lack support.
Stretching Exercises
Specific exercises can strengthen the foot and calf muscles, improving the foot’s overall stability. These may include heel stretches and towel curls.
Physical Therapy
A physical therapist can provide a regimen of exercises and stretches to improve foot strength and mobility. They can also advise on proper footwear and the use of orthotic devices.
Weight Management
Reducing weight can decrease the pressure on the feet, alleviating symptoms for overweight people.
Pain Relief Medications
Over-the-counter pain relievers such as ibuprofen or acetaminophen can be used to manage pain and inflammation associated with flat feet.
Rest and Ice
Resting and applying ice can help reduce swelling and relieve discomfort, especially after prolonged periods of standing or walking.
Surgical Treatment Options
Surgery for flat feet is considered when non-surgical treatments fail to relieve symptoms, and the condition significantly interferes with daily activities. Common surgical procedures include:
- Tendon Repair
If a key tendon contributing to the foot arch is damaged or elongated, surgery may be done to repair or strengthen it. - Osteotomy
This involves cutting and realigning bones in the foot to correct deformities. Bone grafts may also be used to support the arch. - Arthrodesis
This procedure fuses bones within a joint. It is often used in more severe cases or when arthritis is present. It stabilises the foot but can reduce its flexibility. - Lateral Column Lengthening
This procedure involves adding a bone graft to the foot’s outer side to improve arch height and stability. - Excision
Removal of bone spurs or other structures that may contribute to pain and discomfort. - Implants
Insertion of implants to support the arch and reduce overpronation.
Dr. Kau Chung Yuan
MBBS (S’pore)
MRCS (Ireland)
MMed (Ortho)
FRCSEd (Ortho)
Dr Kau (许医生) is a Fellowship trained Orthopaedic Surgeon with a subspecialty interest in Hip and Knee surgery and has been in practice for more than 15 years.
He is experienced in trauma and fracture management, sports injuries, and joint replacement surgery.
- Fellow of the Royal College of Surgeons Edinburgh, Orthopaedics (FRCS, Edin) 2014
- Master of Medicine (Orthopaedics), Singapore (MMed) 2013
- Member of the Royal College of Surgeons Ireland (MRCS, Ire) 2009
- Bachelor of Medicine and Surgery (MBBS, Singapore) 2004
Prevention Strategies
While not all cases of flat feet can be prevented, especially those due to genetic factors, certain measures can be taken to reduce the risk or mitigate the symptoms of flat feet.
- Maintain a Healthy Weight: Excess weight puts additional strain on the feet. Keeping a healthy weight can reduce the risk of flat feet developing or worsening.
- Wear Supportive Footwear: Shoes that provide good arch support and cushioning can help prevent flat feet from developing. Avoid wearing high heels or other footwear without proper support for extended periods.
- Regular Foot Exercises: Strengthening and stretching exercises for the feet and lower leg muscles can help maintain proper foot alignment and arch height.
- Avoid Excessive Stress on Feet: Be mindful of activities that put excessive stress on your feet. Incorporate breaks and vary your activities to prevent overuse.
- Proper Footwear in Sports: Athletes should wear appropriate footwear that offers support and shock absorption to reduce the risk of foot injuries and conditions like flat feet.
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Frequently Asked Questions (FAQs)
Can Flat Feet Be Cured?
Flat feet can be managed effectively, but they are usually permanent. Non-surgical treatments can alleviate symptoms and improve functionality but do not “cure” the condition.
Is Walking Barefoot Good for Flat Feet?
Walking barefoot may benefit people with flat feet by strengthening foot and leg muscles. This can support the arches and improve foot mechanics. However, it is important to approach this gradually and cautiously to avoid overexertion.
People with pre-existing foot conditions or severe flat feet should consult a specialist before significantly changing their walking habits or footwear choices.
Can Flat Feet Be a Sign of a More Serious Condition?
Flat feet can sometimes indicate an underlying issue, such as tendon damage or a neurological condition. If they develop suddenly or are accompanied by pain and swelling, they must be evaluated.