Flat Feet: A Common Problem to Understand

Introduction

Flat feet are a relatively common condition that affects a large number of people around the world. It is characterized by the absence or collapse of the plantar arch, resulting in a plantar surface that is entirely or almost entirely in contact with the ground. While some individuals may live without major symptoms, others may experience pain, posture disturbances, or difficulty walking, depending on the severity of the problem. This introduction aims to shed light on the potential causes, manifestations, and treatment options to better understand this condition.

Definition of flat foot

Flat foot is a presentation in which the arch of the foot, i.e. the curve formed by the bones and tissues that support the weight of the body, is sagging or absent. In other words, this part of the arch of the foot touches the ground entirely or almost entirely when standing. This characteristic can be present from birth (congenital flat foot) or develop with age due to poor posture or injury to tendons and ligaments as is the case in adult acquired flat foot, also called posterior tibial tendon dysfunction.

Prevalence and health impact

According to a study by the American Academy of Orthopaedic Surgeons, about 20-30% of the world’s population has flat feet. This problem can affect one or both arches and may be more common in older adults and those with obesity issues. Although some people live without significant symptoms, flat feet can lead to pain in the feet, ankles, legs, and even the back, as well as postural instability that can cause injury.

Causes and Risk Factors

Genetic and congenital factors

Flat feet can be inherited genetically, especially in the case of congenital flat feet. In this case, the bone structure and tissues that support the arch may be defective from birth.

Injuries or illnesses

An injury to the foot, ankle, or Achilles tendon can also lead to a collapse of the arch of the foot. In addition, certain diseases such as inflammatory arthritis, neuropathy, or loss of sensation, which can be a complication of diabetes, or neurological problems can cause muscle weakness and consequently lead to flat feet.

Environmental and lifestyle factors

Poor posture, obesity, lack of exercise, and wearing inadequate footwear can also contribute to the development of flat feet. Spending a lot of time standing or performing activities that put excessive strain on the feet can also increase the risk of developing this problem.

Symptoms and diagnosis

Symptoms

Symptoms associated with flat feet can vary in intensity and include:

  • Pain in the arch, heel, forefoot, or ankle
  • Abnormal gait or lameness
  • Fatigue and stiffness in the feet after physical activity
  • Instability or weakness of the ankles
  • Swelling of the feet and ankles

Diagnostic methods and evaluation

To diagnose flat foot, our podiatrists will perform a physical examination and ask questions about the symptoms experienced. Then, they will do a biomechanical examination, an analysis of gait and standing posture as well as a study of plantar pressures. X-rays may also be used to assess the bone structure of the foot and determine if there is a collapsed arch. Your podiatrist can also do certain clinical tests, for example to assess the strength of certain muscles.

Complications and consequences

Impact on gait and balance

People with flat feet may have difficulty walking or maintaining balance due to the lack of support in their feet. This can lead to abnormal posture and cause pain in other parts of the body, such as the knees, hips, and back.

Risk of injury

The lack of stability and misalignment caused by flat feet can increase the risk of ankle, knee, and hip injuries. Athletes and people who regularly engage in physical activity may be particularly vulnerable.

Development of joint problems

Flat feet can also cause excessive wear and tear on the foot and ankle joints, which can lead to arthritis problems and other long-term joint complications. The big toe joint, which is particularly stressed as a pivot when walking, is at risk of partially blocking in the presence of a flat foot. This often leads to premature wear and tear of the joint, which is called osteoarthritis.

Impact on quality of life

The pain, discomfort, and physical limitations caused by flat feet can significantly affect a person’s quality of life. Daily activities such as walking, running, and even standing for long periods of time can become difficult and uncomfortable.

Treatment and management

There is no one-size-fits-all treatment for flat foot, as it will depend on the underlying cause and severity of the symptoms. In some cases, flat feet may not require treatment if the symptoms are mild and do not cause discomfort or interfere with daily activities. However, in cases where flat foot is more severe and affects a person’s quality of life, there are several treatment options available. Non-surgical approaches such as custom-made foot orthotics, strengthening and stretching exercises, and wearing appropriate footwear can help improve foot stability and reduce symptoms. In addition to the main treatments, ancillary care such as massage and stretching can also be beneficial in relieving the pain and discomfort caused by flat foot. In rare cases, surgery may be recommended if symptoms do not improve with other treatments or if the underlying cause of flat foot requires correction. There are different types of surgical procedures available, each with its own advantages and disadvantages. It is important to discuss in detail with your healthcare team. It should be noted that surgery is generally only offered as a last resort if other treatments are not effective. It is not widely used in Quebec and Canada to treat pain associated with flat feet.

Prevention and advice

Adopting the best practices can make all the difference for people with flat feet. Targeted exercises to strengthen the arch and ankle muscles help support the foot and improve its alignment. During physical activities or when you are on your feet for a long time, be alert to signs of fatigue or discomfort and give yourself breaks to avoid aggravating symptoms. Finally, choosing the right footwear with good arch support and adequate cushioning is key to maximizing your comfort and preventing pain.

Conclusion

In summary, flat feet are a common problem that can be caused by a variety of factors such as genetics, injuries, or certain health conditions.

 

If you have any concerns about your feet, we advise you to make an appointment for an evaluation with one of our podiatrists. Call us at 819-800-1212 or fill out the contact form to request an appointment.