Babies are often born with flat feet, which may persist well into their childhood. This occurs because children?s bones and joints are flexible, causing their feet to flatten when they stand. Young babies also have a fat pad on the inner border of their feet that hides the arch. You still can see the arch if you lift your baby up on the tips of the toes, but it disappears when he?s standing normally. The foot may also turn out, increasing the weight on the inner side and making it appear even more flat.
Most cases of flatfeet are simply the result of normal development. When that is not the case, the condition can be caused by a number of factors, including the following, Age, disease, injury, obesity or being overweight, physical abnormality, pregnancy. Flattened arches in adults may result from the stresses of aging, weight gain, and the temporary increase in elastin (protein in connective tissue) due to pregnancy. In some cases, flatfeet are caused by a physical abnormality, such as tarsal coalition (two or more bones in the foot that have grown together) or accessory navicular (an extra bone along the side of the foot). The effects of diseases such as diabetes and rheumatoid arthritis can lead to flatfeet. An injury (e.g., bone fracture, dislocation, sprain or tear in any of the tendons and ligaments in the foot and leg) also can cause flatfeet.
Some people have fallen arches, and they aren?t even aware of it, fallen arches are sometimes asymptomatic and do not always cause pain. However, for others, the following symptoms may be present. Foot pain, particularly in the arches or heels, leg or back pain, feet feel tired quickly, swelling in the feet and difficulty moving the feet.
An examination of the foot is enough for the health care provider to diagnose flat foot. However, the cause must be determined. If an arch develops when the patient stands on his or her toes, the flat foot is called flexible and no treatment or further work-up is necessary. If there is pain associated with the foot or if the arch does not develop with toe-standing, x-rays are necessary. If a tarsal coalition is suspected, a CT scan is often ordered. If a posterior tibial tendon injury is suspected, your health care provider may recommend an MRI.
Non Surgical Treatment
The treatment is simple for flat feet. We will carry out a biomechanical assessment and full history, often along side a Computerised Gait Scan to give us an idea of how the foot is compensating. Treatment will be to, control how the foot hits the ground, support the middle of the foot and prevent the arch collapsing, promote normal movement in the front of the foot. The ability to do this will be dictated by the movement within the foot to start with. Treatment for all the above problems are often combined with a physiotherapy session in order to help develop a stretching and strengthening program for the back of the legs and the pelvis in order to allow normal function when the orthoses have been prescribed. If you are born with flat feet you will not grow out of them - if you get orthoses, like glasses you will need them for the rest of your life if you want to correct the mechanics in your foot. In 95% of cases, orthoses will reduce symptoms by at least 85%. In the other 5% we will work with them to get them to this level.
This is rare and usually only offered if patients have significant abnormalities in their bones or muscles. Treatments include joint fusion, reshaping the bones in the foot, and occasionally moving around tendons in the foot to help balance out the stresses (called tendon transfer).
Time off work depends on the type of work as well as the surgical procedures performed. . A patient will be required to be non-weight bearing in a cast or splint and use crutches for four to twelve weeks. Usually a patient can return to work in one to two weeks if they are able to work while seated. If a person's job requires standing and walking, return to work may take several weeks. Complete recovery may take six months to a full year. Complications can occur as with all surgeries, but are minimized by strictly following your surgeon's post-operative instructions. The main complications include infection, bone that is slow to heal or does not heal, progression or reoccurrence of deformity, a stiff foot, and the need for further surgery. Many of the above complications can be avoided by only putting weight on the operative foot when allowed by your surgeon.