All you need to know about flatfoot
Flatfoot is one of the most common problems affecting both children and adults. People with flat feet tend to have a medial arch of the foot which is lower than normal. Around 20-25% of India’s population has flat feet. While a majority of patients do not get any significant problems, there are some children and adults who are severely disabled by the pain and deformity. Some of the causes of flatfoot include:
Tarsal coalitions: A condition where foot joints grow together and restrict movement of that joint Ligament laxity in congenital diseases such as Marfan syndrome or Ehlers-Danlos syndrome Genetic factors: You are more prone if your parents or somebody else in your family has it Patients with neurological or muscular diseases such as cerebral palsy and muscular dystrophy are more prone to this condition
It is important to know that a majority of children aged two to three years appear flat-footed and the arch starts developing after this age. About 40% of children are flat footed at the age of seven, and about 20% continue to have flat feet, even when they become adults.
There are two types of flatfoot in children. If the arch of the foot appears when the child is not walking and flattens out when he is, then it usually is an indicator of being a correctable flat-foot. If the inside arch of the foot appears flat whether the child is walking or resting then it is usually a non-correctable flatfoot.
A flexible flatfoot causes little problem and is compatible with long-term functioning. A rigid flatfoot is a cause of concern and requires assessment and treatment early in childhood So children with flatfeet should be assessed by a specialist orthopaedic surgeon to determine the type of flatfoot and its treatment.
WHY DOES A CHILD HAVE FLATFOOT
Majority of flatfeet in children are developmental, it is a normal occurrence from birth and improves as the child grows. Children who have flatfeet in their teenage years and have symptoms such as pain on running, may require treatment.
WHAT TO DO IF ONE DEVELOPS FLATFOOT
If you did not previously have a flat foot and have developed one now, this is a cause of concern. This is usually due to weakness of the tibialis posterior muscle on the inside of the ankle, which is the main muscle supporting the arch. The muscle weakness is aggravated by weight gain, hormonal changes, pregnancy and diabetes, or an injury. Consult an orthopaedic surgeon for advice and assessment.
SYMPTOMS OF FLATFOOT
The first symptom of flatfoot is general foot fatigue. Patients often complain about not being able to match their walking frequencies with their peers. Activities such as running and jumping become even more difficult. A prominent symptom of flatfoot is pain, which starts from the foot and then spreads to different parts of your body, including arch of the foot, calf, knee, hip, lower back and lower legs.
TREATMENT FOR FLATFOOT
Initial treatment includes strengthening and stretching exercises and supportive and well-fitted shoes. These kind of shoes relieve pressure on the arch and reduce pain if the feet roll too far inward. People with posterior tibial tendonitis might also benefit from getting a custom fitted insole with a medial arch support into their footwear, as this should relieve some of the load that the body places on the tendon tissue. Wearing an ankle brace would be beneficial until inflammation reduces.
If these do not work, surgery may be necessary.
Surgery includes procedures for re-aligning the bones of the foot into the normal shape. Children with rigid flatfoot will require early surgery. Latest techniques for surgical correction allow early recovery and less pain.
According to the American Academy of Orthopaedic Surgeons (AAOS), there are some exercises that improve strength and flexibility in the feet and ankles, which may help in relieving symptoms. These are:
Heel cord stretching: Stand facing a wall and place one hand on the wall at eye level. Place the other leg, with the knee bent, in front of the straight leg and push your hips toward the wall. Stretch your calf to the point where you feel a strong pull but no pain. Bend the knee of the front leg until you feel a stretch in the back leg. Hold for 30 seconds and then rest for 30 seconds. Repeat nine more times.
The golf ball roll: As the name suggests, this exercise requires a chair and a golf ball. Sit on the chair with your feet firmly on the ground. Place the golf ball under the foot, and roll it forward and back under the arch of the foot for two minutes to stretch the plantar fascia ligament.
Arch lift: Stand with your feet directly underneath your hips. Make sure, your toes are in contact with the floor the entire time, roll your weight to the outer edges of your feet as you lift your arches up as far as you can. Then release your feet back down. You’ll work the muscles that help to lift and supinate your arches. Do two to three sets of 10–15 repetitions.
FOOTWEAR ONE SHOULD OPT FOR
With flat feet, it’s imperative to pay extra attention when choosing shoes for necessary support. People should go for shoes which include:
Structured shoes that are neither too cushioned nor too hard Shoes with arch support Shock-absorbing soles While flatfoot is completely treatable, it is best not to neglect early symptoms, so that the condition doesn’t worsen.