Condition Spotlight: Pes planus (Flat Feet)

What is Pes Planus?

A pes planus foot type is one that involves a low arch and is also known as a flat foot.

It is a term that encompasses a range of foot types where the arch collapses at one point or another.

In adults it may be referred to as an adult acquired flat foot.

There are often multiple factors that contribute to a flat foot, including structural abnormalities, hypermobility, soft tissue laxity and various health conditions.

Generally speaking, there are 3 types of flat feet that we see at the clinic.

  • Flat feet that remain that way when sitting, standing and walking.
  • Feet that only flatten when standing and seem to be in a neutral position when sitting.
  • Feet that flatten only when walking or running, but are in a neutral position when standing still or sitting.

What do flat feet feel like?

For some people, their flat feet don’t cause them any pain.

These people are very lucky!

However, most people will develop pain associated with flat feet at some point in their lives.

In children, pain may arise as they are growing or if they are very active.

It is a progressive condition and pain may develop over time.

Some patients describe feeling unstable on their feet or experience a constant feeling of discomfort.

They may also struggle to find footwear that makes them feel comfortable.

What causes pes planus?

A pes planus foot type can be caused by a number of factors.

They are categorised below, based on their cause:

  • Acquired – due to trauma or inflammatory arthritis.
  • Congenital – (present at birth)
  • Functional – involving the position of the joints within the feet, as well as weakness of certain muscles such as the tibialis posterior.
  • Neurological – some neurological conditions can result in a flat foot, such as cerebral palsy and muscular dystrophy.

Genetics also plays a large role in pes planus – a large number of patients will say that their parents or grandparents also have flat feet.

Our feet also tend to ‘flatten’ as we age, due to the structures becoming a little more relaxed.

Who does pes planus affect?

Anyone in the population can have a pes planus foot type.

Those who typically have pain are usually quite active or spend long periods of time on their feet.

How is pes planus diagnosed?

It is very important that we understand exactly why you have a flat foot.

We will conduct a thorough assessment of the foot and ankle to understand how they function and which areas are problematic.

This usually involves testing your range of motion and muscle strength, as well as observing your foot position when you are sitting, standing and walking/running.

This will allow us to see exactly when the foot is flat and helps us to address those specific weaknesses or imbalances in a personalised treatment plan.

How is pes planus treated?

It is important to note that most of us are actually born with flat feet!

Your arch will usually develop throughout childhood and into puberty just like the rest of the body.

In some cases, we will need to intervene and treat children with flat feet, but in some cases it is more of a watch and wait strategy to see how the feet develop.

Prevention is generally better than cure, therefore if you think that you have flat feet, it is important that you seek treatment earlier rather than later.

Some of the ways we treat pes planus feet include:

Taping

Taping is used to support the feet and provide slight correction of alignment.

It is generally used as a precursor to orthotics as it will help to determine whether extra support is necessary.

Orthotics

Orthotics can help to support the structures that need it the most, as well as realign the foot to allow it to function effectively at each affected joint.

This can help to significantly reduce pain in the feet.

Footwear advice

Footwear plays a major role in pes planus feet. Most shoes will not provide adequate support to flat feet.

We will provide advice on the best shoes for your feet, particularly if you also require orthotics.

Stretching and strengthening program

Stretching and strengthening the soft tissue in the area can help to relieve tension and pain.

This will depend on your level of muscle strength, flexibility and range of motion and will be tailored to your specific needs.

Common exercises can include calf stretches, calf raises and theraband exercises.

Dry needling

Dry needling involves the use of an acupuncture needle into a trigger point within the muscle.

The aim of trigger point dry needling is to relax the trigger point in order to reduce your pain.

Shockwave therapy

Shockwave therapy involves the application of acoustic waveforms into the affected tissues in order to create a healing response.

It can be used for acute and chronic conditions to assist with pain relief and to speed up the healing process. It stimulates the regeneration and repair of the injured structures.

Surgery (in severe cases)

In some cases, reconstructive surgery is necessary to repair the affected structures, such as the tibialis posterior tendon.

If you have flat feet

If you believe that you might have a pes planus foot type you can always book in to see us for an assessment. Our podiatry team is highly experienced in assessing, diagnosing and treating people who have flat feet and we’re ready to help you today.

You can book in to see us at our Watsonia based clinic by calling us on 03 9423 2689 or online here.

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