Pes Planus?
Overview
Feet are very variable in shape within and between ethnic groups as well as in populations generally. There is not a normal profile but a wide variation with people with foot profiles at the extremes being very high arched or very low arched, with most people somewhere nearer the middle. What will dictate the general profile of a foot is the bony shape and the soft tissue support. The first thing to say about flat feet and fallen arches is that they are not medical terms and therefore have different meaning to different people. Therefore this question is not as easy as it first might seem. Pes Planus is the medical term for flat feet.
Causes
There are several reasons why arches fall. It can be genetic, it can be a result of unsupported shoes, a product of our lives and the pressure we put on the feet. Some people have active lifestyles so the wear and tear effect on the muscles there that runs down the back of the calf and wraps around the arch can slacken as we get older. It can be a number of things.
Symptoms
Depending on the cause of the flatfoot, a patient may experience one or more of the different symptoms below. Pain along the course of the posterior tibial tendon which lies on the inside of the foot and ankle. This can be associated with swelling on the inside of the ankle. Pain that is worse with activity. High intensity or impact activities, such as running, can be very difficult. Some patients can have difficulty walking or even standing for long periods of time. When the foot collapses, the heel bone may shift position and put pressure on the outside ankle bone (fibula). This can cause pain on the outside of the ankle. Arthritis in the heel also causes this same type of pain. Patients with an old injury or arthritis in the middle of the foot can have painful, bony bumps on the top and inside of the foot. These make shoewear very difficult. Occasionally, the bony spurs are so large that they pinch the nerves which can result in numbness and tingling on the top of the foot and into the toes. Diabetics may only notice swelling or a large bump on the bottom of the foot. Because their sensation is affected, people with diabetes may not have any pain. The large bump can cause skin problems and an ulcer (a sore that does not heal) may develop if proper diabetic shoewear is not used.
Diagnosis
You can always give yourself the ?wet test? described above to see whether you have flat feet. Most people who do not notice their flat feet or have no pain associated with them do not think to see a foot doctor. Flat feet can lead to additional problems such as stiffness or pain, however, especially if the condition appears out of nowhere. If you think you may have flat feet, you should seek medical attention to ensure there are no additional issues to worry about. Your doctor will be able to diagnose you with a number of tests. For example, he or she may have you walk around, stand still, or stand on your tiptoes while you are being examined. Your doctor may also examine your foot?s shape and functionality. It?s important to let your foot doctor know about your medical and family history. In some cases, your doctor may order imaging tests such as x-rays or an MRI (magnetic resonance imaging) to determine a cause of your flat foot. If tarsal coalition is suspected in children, a CT scan is often ordered.
pes planus radiology
Non Surgical Treatment
During walking and running, there is a small natural inward drop (slight pronation) that is part of the spring and propulsion. Allowing exaggerated sagging is like rounding your shoulders too much. Legs and feet have posture that you can control yourself. Use your own muscles and get free built-in exercise and arch support all day, and stop painful poor positioning. Some people with existing abnormality or growths in the ball of the foot will roll inward (or outward) to get the pressure off the deformed area because standing straight hurts. See your doctor first. Remember, don't force. If it hurts, it's wrong. All you are doing is learning how to stand neutral, not tilted so much that you compress the joints. The concept is to hold your feet in the same healthful position that shoe supports would. It is like an ice skater holds their skates straight at the ankle, not angled.
Surgical Treatment
Feet that do not respond to the treatments above may need surgery. The surgery will help to create a supportive arch.
Feet are very variable in shape within and between ethnic groups as well as in populations generally. There is not a normal profile but a wide variation with people with foot profiles at the extremes being very high arched or very low arched, with most people somewhere nearer the middle. What will dictate the general profile of a foot is the bony shape and the soft tissue support. The first thing to say about flat feet and fallen arches is that they are not medical terms and therefore have different meaning to different people. Therefore this question is not as easy as it first might seem. Pes Planus is the medical term for flat feet.
Causes
There are several reasons why arches fall. It can be genetic, it can be a result of unsupported shoes, a product of our lives and the pressure we put on the feet. Some people have active lifestyles so the wear and tear effect on the muscles there that runs down the back of the calf and wraps around the arch can slacken as we get older. It can be a number of things.
Symptoms
Depending on the cause of the flatfoot, a patient may experience one or more of the different symptoms below. Pain along the course of the posterior tibial tendon which lies on the inside of the foot and ankle. This can be associated with swelling on the inside of the ankle. Pain that is worse with activity. High intensity or impact activities, such as running, can be very difficult. Some patients can have difficulty walking or even standing for long periods of time. When the foot collapses, the heel bone may shift position and put pressure on the outside ankle bone (fibula). This can cause pain on the outside of the ankle. Arthritis in the heel also causes this same type of pain. Patients with an old injury or arthritis in the middle of the foot can have painful, bony bumps on the top and inside of the foot. These make shoewear very difficult. Occasionally, the bony spurs are so large that they pinch the nerves which can result in numbness and tingling on the top of the foot and into the toes. Diabetics may only notice swelling or a large bump on the bottom of the foot. Because their sensation is affected, people with diabetes may not have any pain. The large bump can cause skin problems and an ulcer (a sore that does not heal) may develop if proper diabetic shoewear is not used.
Diagnosis
You can always give yourself the ?wet test? described above to see whether you have flat feet. Most people who do not notice their flat feet or have no pain associated with them do not think to see a foot doctor. Flat feet can lead to additional problems such as stiffness or pain, however, especially if the condition appears out of nowhere. If you think you may have flat feet, you should seek medical attention to ensure there are no additional issues to worry about. Your doctor will be able to diagnose you with a number of tests. For example, he or she may have you walk around, stand still, or stand on your tiptoes while you are being examined. Your doctor may also examine your foot?s shape and functionality. It?s important to let your foot doctor know about your medical and family history. In some cases, your doctor may order imaging tests such as x-rays or an MRI (magnetic resonance imaging) to determine a cause of your flat foot. If tarsal coalition is suspected in children, a CT scan is often ordered.
pes planus radiology
Non Surgical Treatment
During walking and running, there is a small natural inward drop (slight pronation) that is part of the spring and propulsion. Allowing exaggerated sagging is like rounding your shoulders too much. Legs and feet have posture that you can control yourself. Use your own muscles and get free built-in exercise and arch support all day, and stop painful poor positioning. Some people with existing abnormality or growths in the ball of the foot will roll inward (or outward) to get the pressure off the deformed area because standing straight hurts. See your doctor first. Remember, don't force. If it hurts, it's wrong. All you are doing is learning how to stand neutral, not tilted so much that you compress the joints. The concept is to hold your feet in the same healthful position that shoe supports would. It is like an ice skater holds their skates straight at the ankle, not angled.
Surgical Treatment
Feet that do not respond to the treatments above may need surgery. The surgery will help to create a supportive arch.
