The 411 on Flat Feet!
Flat feet come in many forms.
They can be:
- Flexible or Rigid
- Congenital or Adult Acquired
- Painful or Non-Painful
In this blog post, we will focus on two of these types.
1. “Doc, I was born with flat feet. Should I be worried?” - Flexible and Congenital
2. “Doc, my ankle is killing me, and my arches are falling?!” - Adult Acquired
Flexible and Congenital Flat Feet
Congenital flat feet are generally non-painful, flexible (i.e. they move normally), and have been present since birth. For those people with congenital flat feet, you may notice that you have to stick to certain types of shoes. Overall, you like these shoes because they prevent some mild aches in your feet, ankles, knees, or back. However, you can manage with your flat feet as you are so used to them. You may struggle with certain sports - like jumping sports or running. Most of the time, there are simple solutions to ease the mild symptoms of congenital flat feet. If you develop discomfort, use the tips below as guidance for your best approach.
1. Try a pair of full-length orthotics.
Resist the urge to buy a pair with a super high arch. You just need a little bolster to support the middle of your foot and to keep the ankle from sagging inward. I highly recommend the brands SuperFeet® and PowerStep®. You can find professionals to guide you at many running stores. I am often asked, “Doc, do I need custom orthotics?” I only recommend custom-made orthotics after you have tried a high-quality pair of over-the-counter insoles and are still having pain consistently. Custom-made orthotics are an excellent product but are rather expensive.
2. Try high top athletic shoes for sports.
High top athletic shoes may hold your ankle in a better position and lessen any sports related pain from congenital flat feet. An alternative option is you can even throw on a lace up ankle brace (tightened along the inner ankle) or pull on brace for sports. Overly flexible and flat athletic shoes may cause you trouble. Instead, use shoes with a touch more rigidity and with built in arch support, like Hoka’s® or New Balance®. Minimize repetitive jumping activities like jump roping or playing basketball daily. In contrast, cross train to prevent overuse of the tendons that hold up the arch.
3. Invest in better shoes.
If you are struggling with congenital flat feet, you will want to invest in good footwear. Your footwear does not have to be clunky and unattractive. However, what is fashionable, such as flat ballerina shoes or tall high heels, will not work for you.
Women - stick with cute, lower heels that support the entire bottom of your feet or flats with adequate insoles. Stay away from super flat sandals in the summer that may cause pain in the arch, heel, and inner ankle.
Men - consider dress shoes that come above the ankle, have arch support, and a soft, rubberize outsole for more comfort.
Remember, if your feet are flat, flexible, and DO NOT hurt, then you do not have to do anything. There is no device that will help create an arch over time, so don’t believe the hype. You just need to be vigilant to stay pain free.
Adult Acquired Flat Feet
The medical term for this type of flat foot is Adult Acquired Flat Foot or Posterior Tibial Tendon Dysfunction (PTTD). With this condition, your arch slowly decreases in height over time. Adult acquired flat feet are most often because of a problem with a tendon that lives on the inner part of the ankle and foot that supports the arch. Unfortunately, this tendon is under a lot of strain and prone to problems.
AAOS.com
Risk Factors for PTTD:
1. Overuse and repetitive activities
2. Improper shoe wear
3. Obesity
4. Diabetes
5. Female gender
6. Age
7. Pregnancy
8. Injury to the foot
So how do I know if I have adult acquired flat feet?
Initially, you may have one of the risk factors above, along with swelling and pain, along the inner part of the ankle and foot. You would notice pain while standing on your toes or pain by moving your foot inward. You may even be unable to stand on your toes because of weakness or pain. Why? The tendon that holds up your arch is inflamed and cannot do its job properly. PTTD cannot be properly diagnosed without seeing a doctor. If you are experiencing these issues, please see your local physician.
There are several stages of PTTD and in the early stages, you will not fully develop a flat foot yet. Over time, the condition can progress to where the foot is completely flat, the ankle is rolled inward, and there is arthritis in the joints of the foot and ankle. As doctors, because we know how this condition progresses, we are aggressive in managing it.
What to do about adult acquired flat feet?
~ Stop whatever activity triggered the pain!
~ If you have pain and swelling, see your orthopedic doctor. He or she may recommend a trial of anti-inflammatories along with either orthotics, a brace, or walking boot, dependent on your symptoms.
~ In advanced cases, surgery may be needed.
I hope this helps demystify the flat foot!
Take care of you!
XOXOXO,
Dr. Eva