A flat foot is a term used to described a collapsed arch. Medically, the term is pes planovalgus (for foot flatten and pushed outwards). There are varying degrees of ?flatness?. Though not all flat feet are problematic, however, when there are painful flat feet can cause significant discomfort and activity limitations. There are two kinds of flat feet - flexible (mobile) or rigid (stiff). A flexible flat foot is one where the foot retains motion, and the arch is able to be recreated when there is no weight on the foot. In contrast, a rigid flat foot is ?stuck? in the flat position regardless of whether or not there is pressure placed on the foot.
Flat feet are often hereditary. Arch pain may also be caused by wearing shoes with inadequate support, standing or walking for long periods of time in high heels, or overuse of the feet during work or sports. Being overweight also places additional stress on the feet, especially the arches.
People suffering from pain in the arch sometimes complain of burning or soreness on the foot sole, which is worse in the morning and after physical activity. There may also be some tenderness when pressure is applied to the sole of the foot or heel. In addition to this, patients tend to complain of more pain when they stand on tiptoe.
Diagnosis of a plantar plate tear can often be challenging due to the complex nature of the anatomy of the foot. Careful history taking and an examination of the area of pain is required to determine the extent and cause of the tear. If necessary, further investigations such as x-rays or diagnostic ultrasound may be ordered by your podiatrist to help evaluate the severity of the problem.
Non Surgical Treatment
This is a common foot condition that can be easily treated. If you suffer from arch pain avoid high-heeled shoes whenever possible. Try to choose footwear with a reasonable heel, soft leather uppers, shock absorbing soles and removable foot insoles. When the arch pain is pronation related (flat feet), an orthotic designed with a medial heel post and proper arch support is recommended for treating the pain. This type of orthotic will control over-pronation, support the arch and provide the necessary relief. If the problem persists, consult your foot doctor.
If pain or foot damage is severe, your doctor may recommend surgery. Procedures may include the following. Fusing foot or ankle bones together (arthrodesis). Removing bones or bony growths also called spurs (excision). Cutting or changing the shape of the bone (osteotomy). Cleaning the tendons' protective coverings (synovectomy). Adding tendon from other parts of your body to tendons in your foot to help balance the "pull" of the tendons and form an arch (tendon transfer). Grafting bone to your foot to make the arch rise more naturally (lateral column lengthening).
To prevent arch pain, it is important to build up slowly to your exercise routine while wearing arch supports inside training shoes. By undertaking these simple measures you can prevent the discomfort of arch pain which can otherwise linger for many months. While you allow the foot to recover, it will help to undertake low impact exercises (such as swimming or water aerobics).
Gastroc stretch. Stand on the edge of a step. Rise slowly on your toes. Lower yourself slowly as far as you can until you feel a stretch in your calf. Don?t roll your foot inward or outward. Hold for 1-2 seconds. Reps:10-20 (stop before you fatigue). Soleus stretch. Same as above, but start with your knee bent so that you feel a slight stretch in your calf or achilles. Maintain the angle of your knee throughout the stretch. Bicycle stretch. Lie on your side. Keeping your top leg straight, bring your knee toward your nose until you feel a slight stretch in the hamstring. Maintaining this angle at your hip, start pretending you are pedalling a bicycle with the top leg. Make sure you feel a slight stretch each time your knee is straight. Reps: 10-30 for each leg. If you feel any pops or clicks in your hip or back, try raising the top leg a little (making the thighs further apart) to eliminate the popping. Foot Intrinsic Exercises. Assisted metatarsal head raising. Sit in a chair. Find the bumps at the ball of your foot just before your big toe and just before the little toe. These are the first (big toe) and fifth (little toe) metatarsal heads. Place your second and third fingers from one hand under the first metatarsal head, and the second and third fingers from the other hand under the fifth metatarsal head. Now lay the thumbs from each hand in a diagonal across your toes so that they form a right angle meeting at the nail of the second toe. Your hands are now in position to assist your toes. Keep your toes straight, with the toe pads on the floor. Use your fingers to help raise all the metatarsal heads (the ball of your foot). Do not let your toes curl under keep them long. Now relax. Reps 7-10 for each foot. As this exercise gets easier, let your fingers do less of the work until your toes can do the exercise unassisted. This can take up to three weeks. When your strength has improved to this point, you can progress to the following three exercises, which are best done in stocking feet on a slippery floor. Active metatarsal head raising. Stand with your weight on both feet. Raise your metatarsal heads (the ball of your foot) while keeping your toes from curling under and maintaining your heel on the ground. Relax. Reps 6-7. Do one foot at a time. If you do more reps than you are ready for, you may well develop cramping in your foot. I once had a client who thought if seven reps were good, 10 were better. For good measure, she did the 10 reps 10 times in a day, and then she was unable to walk the next day from having used a set of muscles she had never exercised before. Don?t overdo it.