Flat foot is the loss of the medial longitudinal arch of the foot. It is also called as pes planus.
At birth we all have flat feet, arches develop around 3 years of age.
Flat feet is of two forms; flexible and rigid. When the arch is intact with elevation of the help and non-bearing but disappears on full standing, it is termed flexible flat foot while rigid flat foot is when the arch is not present in both of these activities,
- Congenital deformity
- ligamentous laxity
- presence of the accessory navicular bone
- foot and ankle injuries
- genetic malformations
- overuse causing arch weakness
Bones involved in medial arch- calcaneus, navicular, talus, first three cuneiforms, and the first three metatarsals
Supportive structures of arch- posterior tibial tendon, plantar ligament, deltoid ligament, flexor hallucis muscles
Dysfunction, overuse, excess tension of above structures cause acquired flat foot.
- Pain along the course of the posterior tibial tendon
- May have inverted ankles
- Possible oedema
- Contracture of muscles at the lateral compartment
- Uneven distribution of body weight and improper weight bearing
Physical Therapy Management-
Rehab helps minimize pain, increase foot flexibility, strengthen muscles.
Pain management includes rest, activity modification, icing, electric agents.
Exercise rehab- it includes stretching and strenghtenin exercise, training of gait, proper weight bearing, training balance exercises, and training proprioception.
- Counselling – wear proper footwear, suggestions for motion control shoes, use of insoles or orthotics and braces are also needed.
- Obese and overweight individuals- encouragement of weight loss through exercise and dieting