WHAT ARE FLAT FEET??

"Flat Feet" is the term most often used to describe a foot type in which the entire plantar or bottom of the foot is in contact with the ground, while a person is standing. Often, this can be seen in children, when they are just beginning to walk. This is because the child has baby fat on the underside of the foot, and because the foot has not yet completely developed. However, as the baby develops into adolescence and then into adulthood, most of the time, the feet with achieve an arch. This arch may vary from below normal, normal to a cavus or high arch foot type.

BELOW, IS A BABY'S FOOT. YOU CAN SEE THAT THERE IS MOSTLY BABY FAT AND NO REAL ARCH.


While the child is growing, it is important to keep watch on the development of the child's feet. Sometimes, flat feet can be genetic, and other times it is an acquired deformity. If the child complains of pain while running and walking, and if one or both feet exhibit a flat arch, or no arch, it is important to go to a health care professional, such as a podiatrist or a foot and ankle specialist to further examine the child's feet.

Flat feet can be either Congenital or Acquired.

A congenital flatfoot is a genetic abnormality, and is often also a Rigid flat foot. This is when the bones of the foot, which are otherwise separate in a normal child, may be abnormally fused in the foot. This condition is called Tarsal coalition. The abnormal fusion of bones in the foot often leads to pain on ambulation and pain on any normal movement of the foot. The low arch is also clearly visible. If a child does exhibit these signs and symptoms, it is important to go to a health care professional for further evaluation. The doctor will do a series of clinical examinations and it may be necessary to do a CT or a computed tomography exam to rule out a tarsal coalition. If a tarsal coalition is found, surgical intervention may be necessary.

THIS IS A TYPICAL COALITION OR FUSION OF THE TWO BIGGEST BONES IN THE FOOT, THE TALUS & THE CALCANEUS.


An acquired flat foot often will develop on only one foot, however in some cases bilateral or both feet have also been observed to become flat. Acquired flat foot conditions include tendonitis or tendon ruptures which could lead to flat feet. The most common tendon affected in acquired flat foot is the posterior tibial tendon. This tendon is located on the medial aspect or the inside of the foot; it wraps around the middle of the foot, acting like a pully to help lift up the arch. When this tendon fails to do its job, people will often complain of fallen arches, or an acquired flat foot deformity. If any of these symptoms are present, it is again important to go directly to a health care professional for further evaluation. An MRI or a Magnetic Resonance Imaging may be the first test that would need to be done. An MRI will be able to differentiate a tendonitis versus a tendon tear.
The treatment for a tendonitis can be as simple as rest, ice, elevation and anti-inflammatories to relieve the pain. Orthotics may also be necessary to slow down the progression of the deformity. In other instances, if the there is a tendon tear or a complete rupture, surgical intervention may be necessary to approximate the ends of the tendon back together.

THIS IS A "FALLEN ARCH" MOST COMMONLY DUE TO A POSTERIOR TIBIAL TENDONITIS, OR A TENDON TEAR.


Flat feet can also be just flat feet, where the medial arch of the foot is just lower than usual and there is no known cause for this. This type of flat foot is called Idiopathic Flat foot. Most people with no congenial or acquired causes as listed above have flexible flat feet, which can be easily corrected with conservative measures. In this case, the only symptoms may be that the individual tires easily, and because of this, he or she may not be able to participate in many sports related activities. If this is the case, a simple orthotic may be the treatment of choice. Orthotics can be custom made. They are devices that go into the shoe which help to support the arch and to hold the foot in a more corrected and efficient position for optimal movement and ambulation.