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What causes Flat Feet? - Huntington Beach CA
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A flat foot, also known as pes planus, is found on the medial aspect of the
foot when the arch fails to develop and touches the floor. The condition normally
presents in infants and toddlers; it only becomes an issue in adulthood if the arch
does not eventually develop. Most adults with flat feet will not have any
complaints, but to experience pain or achy feet is not unusual. Flat feet is
associated with the following symptoms:
-Pain on the medial aspect of the foot, in the arch
-Achy and tired feet at the end of a day or after long periods of standing on feet
-Tight calves (Achilles Tendon)
-Numbness from compression of the tibial nerve
-Arthritis of the lateral ankle from compression
-Associated knee pain
The pain with flat feet can be attributed to weakness in the tendons leading to
failure of arch formation. When palpating the foot, you may also notice swelling
on the medial ankle due to the constant compression.
Flat feet are often differentially diagnosed with tarsal tunnel syndrome and
plantar fasciitis, or heel spurs, because of similar symptoms. To confirm that the
flat feet are not flexible, have the patient stand on their toes and observe for the
formation of an arch. If an arch is formed, that is indicative that the flat feet are
flexible and there is no major underlying condition. If the arch does not appear
when standing on the toes, further imaging may be necessary to confirm there is
no other underlying condition causing the deformation of the foot such as tarsal
coalition.
With plantar fasciitis, the patient may be able to pin point the sharp pain
on the heel of the foot and will be exacerbated by putting any weight on the foot
or excessive duration of exercise. A good way to diagnose tarsal tunnel
syndrome is, Tinel's test; you can tap the tarsal tunnel where the nerve passes
through, and if the symptoms are reproduced then it is highly probable.
Treatment of flat feet can vary depending on how chronic the condition is.
In rare cases surgery to fuse the tarsals can be performed to decrease the
pressure on the arch and vasculature. If you're considering foot surgery, discuss
the benefits and risks with your doctor. Other invasive options include surgery of
the tendons to repair the area.
Conservative treatment is preferred, and can have lasting results if managed properly. Icing the area for no more than 20 minutes every 2 hours can help with the inflammation.
Some sources recommend an orthotic to provide support for the medial arch and to relieve pressure on the nerve. The most effective form of treatment would be to address
the scar tissue that has built up over time from overuse and adjust any
subluxations of the foot and ankle. Once the symptoms have subsided and the
scar tissue has healed, the next phase of treatment would be to keep stretching
the muscles of the plantar fascia and medial arch of the foot and to strengthen
them to prevent future injury.
Warm up of the muscles is important and can be done with simple arch
stretching and continued on with the strengthening program. With flat feet,
it is common to find tight calves. A good stretch for the calves is downward
facing dog yoga pose. This pose serves dual purpose for flat feet, in that it
stretches the tight calves and is exercising the tendons with weight on the balls
of the feet. Exercises to strengthen the tendons associated with flat feet will
include proprioceptive activity with one-legged stances and diagonal reaches.
Approximately 6-8 weeks of treatment will be needed to decrease the pain and
strengthen the muscles.
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