Fallen arches, flat feet. We’ve all heard these expressions. But what do they mean? And how do you know if you have flat feet (which refer to fallen arches)?
Normal feet tend to form a little arc on the underside, like the curve of a rainbow. This means that the tendons attaching the heel and foot bones are doing their job.
You can tell if you have flat feet with a simple test. Dip your feet in a tub of water, then stand on a dry surface, such as a wooden floor or a concrete sidewalk, where your footprint will show. Then step away and look at the wet print. If you see the entire foot, you’ve probably got fallen arches. A foot with a good arch will have a gap in the middle where the sole of the foot is slightly above the pavement.
Many children have flat feet but their arches develop as they grow older.
As for adults, the condition can be caused by stretched or torn tendons, broken or dislocated bones in the foot, or a nerve problem.
What Causes Arches to Fall?
Certain diseases, such as rheumatoid arthritis, can gradually result in fallen arches. Generally, people who are overweight, patients with diabetes, older people and pregnant women are more prone to this condition.
Some people are born with fallen arches. Others suffer damage to the posterior tibial tendon, the PTT, that runs from the lower leg along the ankle to the middle of the arch. This is usually the result of overuse injuries caused by hiking, walking, running or stair-climbing.
With Posteriod Tibial Tendon Dysfunction (PTTD), which is the name of the syndrome, the tendon that is designed to help support the arch becomes inflamed or stretched.
If left untreated, the patient may experience pain along the length of the tendon. As the arch flattens, the foot and toes begin to turn outward and the ankle rolls inward. At this point, the pain may shift to the outside of the foot. If the tendon deteriorates further, arthritis can develop.
Experiencing Foot Pain?
The first clue that you might have flat feet is soreness. You may find you can’t walk or stand for long. Your feet ache on the underside, where the arch should be. You might have trouble standing on your toes. Some patients experience back and leg pain that can be traced to fallen arches.
We can often spot the condition by checking your shoes. If you have an unusual pattern of wear on the shoe, it could indicate fallen arches. We also ask you to perform certain movements such as raising up on your toes. We can test the strength of your muscles and tendons during a physical exam. With some patients, we’ll take x-rays or an MRI to show the inner structure of the foot.
PTT disorders can often be relieved with conservative therapy such as rest, ice to reduce swelling, stretching exercises, or physical therapy.
You may need special footwear or an insert that fits inside the shoe. We sometimes prescribe injections such as corticosteroids to help reduce inflammation.
For advanced cases, there are various surgical procedures, including the removal of bone spurs or irritated synovial tissue (which surrounds the joint), or realigning the bones of the foot. Some patients may need to have certain bones fused, or to have tendons grafted from other parts of the body to form a new arch.
Pay Attention to Foot Pain
The best way to avoid fallen arches is to be aware of your feet. Aching feet are trying to tell you something. Wear footwear that’s appropriate (don’t try to hike in dress shoes, for instance).
Ask your doctor or physical therapist to prescribe some stretching exercises to warm up your feet before strenuous activities. If you have diabetes or high blood pressure, make sure to keep the disease under control.
Contact the clinic if you experience recurring foot pain. Never try to run or walk off soreness. Ignoring subtle cues from your feet could set you up for bigger problems in the long term.