FLAT feet or pes planus, is a very common foot deformity. It is a condition where the arch of the foot collapses, making the sole – partially or entirely – come into contact with the ground.

Most people with this condition show no problematic symptoms and do not require treatment. However, flat feet can cause foot, ankle, calf, knee, hip, and back pain. The condition can also cause stress to be put on areas of the foot leading to the development of corns and calluses. It is more commonly found in women than men, and often those who are obese and over 40 years old. Some neurological conditions like spina bifida and cerebral palsy can also cause flat feet.

THE ARCH OF THE FEET

The function of the arch or instep is to connect the front of the foot to the heel. It acts as an elastic spring to protect the foot from weight-bearing forces.

Parents are often concerned when babies and young children appear to be flat-footed. This is due to fatty tissue and the underdevelopment of the arches. This will usually change before the age of eight. Some children have a laxity in their ligaments and this can cause the condition. These children may become clumsy or limp if they walk for long distances and complain of pain in their knees and calf muscles.

A podiatrist or physiotherapist should be able to assess the child to see if there is need for concern, or to reassure parents and guardians that it is just a developmental phase that should pass.

TREATMENT

Once the condition has been correctly diagnosed, the first line of treatment is to strengthen and support the foot muscles, which will encourage the arch to develop. Allow the child to play barefooted, as long as the surface which they are playing on is safe. Running on the beach is a fun and effective way to build the foot muscles and so too is swimming. Ensure that children wear supportive footwear held securely to their feet. On rare occasions, this isn’t enough and the symptoms are severe enough for orthotics (corrective shoe devices) to be prescribed.

In adults we see flexible and rigid flat feet. This can be differentiated by your podiatrist through a simple test. Most flexible flat feet are asymptomatic and, as mentioned earlier, tend to affect women more than men. Obesity can be a major factor in sustaining, as well as developing the condition. When a rigid flat foot has been diagnosed, this indicates a structural problem with the bones and joints. In both cases, your podiatrist or physiotherapist will recommend strengthening exercises for the Achilles tendon and calf.

Footwear advice is essential as many styles of shoes will exacerbate the symptoms. Anti-inflammatory creams and tablets can be used to relieve pain. In the vast majority of cases, orthotics can prove to be useful, but they must be recommended by a health professional. The incorrect use of orthotics can lead to further problems. Only wear them with the guidance of the prescriber.

Angela Davis BSc (Hons) DPodM MChS is a podiatrist with offices in Montego Bay, Mandeville, Ocho Rios, and Savanna-la-Mar. She is a member of the Health and Care Professions Council in the United Kingdom. Contact her at 293-7119.