Overview
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.
Causes
Stress fractures, plantar fasciitis, and acute and chronic arthritis are most commonly the result of repetitive micro-trauma injuries. Micro-trauma injuries are caused when the structures of the body are stressed and re-stressed to the point that damage occurs in the tissues. Factors that commonly contribute to this injury can be running on uneven surfaces or surfaces that are too hard or too soft, shoes that have poor force-absorption qualities, or going too hard or too long during repeated exercise bouts.
Symptoms
Symptoms of plantar fasciitis may occur anywhere along the arch, but it is most common near its attachment to the heel bone. Symptoms of plantar fasciitis vary, but the classic symptom is pain after rest--when you first get out of bed in the morning, or when you get up after sitting down for a while during the day. This is known as "post-static dyskinesia." The pain usually diminishes after a few minutes of walking, sometimes even disappearing, but the pain is commonly felt again the longer you're on the foot. Fasciitis can be aggravated by shoes that lack appropriate support, especially in the arch area, and by the chronic irritation of long-periods of standing, especially on concrete, and by being overweight. Other factors which influence this condition are gender (females get this more than men), age (30s to 50s are most common), and those with flatter-than-normal feet. It doesn't help that fascia doesn't heal particularly quickly. This is because it has relatively poor circulation, which is why it's white in colour.
Diagnosis
A professional therapist may use tinels test to diagnose tarsal tunnel syndrome. This involves tapping the nerve just behind the medial malleolus or bony bit of the ankle with a rubber hammer. Pain indicates a positive test. Sometimes it is initially mistaken for plantar fasciitis which also causes pain from the inside heel and throughout the arch of the foot. Neural symptoms (such as tingling or numbness) as well as the location of tenderness when touching the area should help to easily distinguish between the conditions.
Non Surgical Treatment
Relieving the pain caused by plantar fasciitis boils down to two basic needs. Reduce the inflammation. Support and stretch the plantar fascia. If you can accomplish those two goals, you should note pain relief more quickly. Doctors treating plantar fasciitis will recommend the following options for accomplishing this. Rest, Get off your feet as much as possible when the pain is at its worst. If you must walk or run, try to stay off hard, unforgiving surfaces and wear supporting footwear. Use ice on the arch several times a day to help reduce swelling if necessary. Take Tylenol, Advil, or other over-the-counter pain relievers that contain acetaminophen, ibuprofen, or naproxen to help lessen the inflammation and ease pain. Stretch your toes, calves, and foot repeatedly throughout the day to keep the plantar fasciia limber. Purchase insoles, inserts, or orthopedic shoes designed to support the arch of the foot and wear them at all times. Purchase splints that will stretch the Achilles tendon as you sleep, helping to lessen morning heel pain. If none of the above helps, your doctor may prescribe regular injections of cortisone to control the pain. As a last resort, your doctor may attempt surgery to repair the plantar fascia.
Surgical Treatment
Cavus foot is caused in part by an over-pull of one of the lateral ankle muscles. A release of this tendon can be performed on the outside of the ankle. Additionally, a transfer of this tendon can be performed to help in correcting deformity of the ankle joint. Often patients will have a tightness of their gastrocnemius muscle, one of the main muscles in the calf. This can increase the deformity or prevent a correction from working. It is addressed with a lengthening of a part of the calf muscle or Achilles tendon. This is often performed through one or more small cuts in the back of the leg or ankle. Finally, the plantar fascia may be tight. The plantar fascia is a cord-like structure that runs from the heel to the front part of the foot. Partial or complete plantar fascia release may be done.
Prevention
Maintain a healthy weight, Use insoles to support your arches, Limit how often you wear high heels, Use proper shoes, especially when exercising to evenly distribute weight through your foot.
Stretching Exercises
Calf Raises. Strengthens the tendons in your heels and calf muscles, which support your arch. Raise up on the balls of your feet as high as possible. Slowly lower down. Do three sets of 10 reps. Progress to doing the raises on stairs (with heels hanging off), and then to single-leg raises. Step Stretch. Improves flexibility in your Achilles tendon and calf-when these areas become tight, the arch gets painfully overloaded. Stand at the edge of a step, toes on step, heels hanging off. Lower your heels down, past the step, then raise back up to the start position. Do three sets of 10 reps. Doming. Works the arch muscles and the tibialis posterior (in the calf and foot) to control excess pronation. While standing, press your toes downward into the ground while keeping the heel planted, so that your foot forms an arch (or dome). Release, and do three sets of 10 reps on each foot. Toe Spread and Squeeze. Targets the interossei muscles of the foot, which support the arch. While sitting, loop a small resistance band around your toes. Spread toes; release. Then place a toe separator (used at nail salons) in between toes. Squeeze toes in; release. Do three sets of 10 reps of each exercise on both feet. Towel Curls. Works the toe-flexor muscles that run along your arch to increase overall foot strength. Lay a small hand towel on the floor, and place one foot on the towel. Using just your toes, scrunch the towel toward you, hold, then slowly push the towel away from you back to start position. Do three sets of 10 reps on each foot.
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.
Causes
Stress fractures, plantar fasciitis, and acute and chronic arthritis are most commonly the result of repetitive micro-trauma injuries. Micro-trauma injuries are caused when the structures of the body are stressed and re-stressed to the point that damage occurs in the tissues. Factors that commonly contribute to this injury can be running on uneven surfaces or surfaces that are too hard or too soft, shoes that have poor force-absorption qualities, or going too hard or too long during repeated exercise bouts.
Symptoms
Symptoms of plantar fasciitis may occur anywhere along the arch, but it is most common near its attachment to the heel bone. Symptoms of plantar fasciitis vary, but the classic symptom is pain after rest--when you first get out of bed in the morning, or when you get up after sitting down for a while during the day. This is known as "post-static dyskinesia." The pain usually diminishes after a few minutes of walking, sometimes even disappearing, but the pain is commonly felt again the longer you're on the foot. Fasciitis can be aggravated by shoes that lack appropriate support, especially in the arch area, and by the chronic irritation of long-periods of standing, especially on concrete, and by being overweight. Other factors which influence this condition are gender (females get this more than men), age (30s to 50s are most common), and those with flatter-than-normal feet. It doesn't help that fascia doesn't heal particularly quickly. This is because it has relatively poor circulation, which is why it's white in colour.
Diagnosis
A professional therapist may use tinels test to diagnose tarsal tunnel syndrome. This involves tapping the nerve just behind the medial malleolus or bony bit of the ankle with a rubber hammer. Pain indicates a positive test. Sometimes it is initially mistaken for plantar fasciitis which also causes pain from the inside heel and throughout the arch of the foot. Neural symptoms (such as tingling or numbness) as well as the location of tenderness when touching the area should help to easily distinguish between the conditions.
Non Surgical Treatment
Relieving the pain caused by plantar fasciitis boils down to two basic needs. Reduce the inflammation. Support and stretch the plantar fascia. If you can accomplish those two goals, you should note pain relief more quickly. Doctors treating plantar fasciitis will recommend the following options for accomplishing this. Rest, Get off your feet as much as possible when the pain is at its worst. If you must walk or run, try to stay off hard, unforgiving surfaces and wear supporting footwear. Use ice on the arch several times a day to help reduce swelling if necessary. Take Tylenol, Advil, or other over-the-counter pain relievers that contain acetaminophen, ibuprofen, or naproxen to help lessen the inflammation and ease pain. Stretch your toes, calves, and foot repeatedly throughout the day to keep the plantar fasciia limber. Purchase insoles, inserts, or orthopedic shoes designed to support the arch of the foot and wear them at all times. Purchase splints that will stretch the Achilles tendon as you sleep, helping to lessen morning heel pain. If none of the above helps, your doctor may prescribe regular injections of cortisone to control the pain. As a last resort, your doctor may attempt surgery to repair the plantar fascia.
Surgical Treatment
Cavus foot is caused in part by an over-pull of one of the lateral ankle muscles. A release of this tendon can be performed on the outside of the ankle. Additionally, a transfer of this tendon can be performed to help in correcting deformity of the ankle joint. Often patients will have a tightness of their gastrocnemius muscle, one of the main muscles in the calf. This can increase the deformity or prevent a correction from working. It is addressed with a lengthening of a part of the calf muscle or Achilles tendon. This is often performed through one or more small cuts in the back of the leg or ankle. Finally, the plantar fascia may be tight. The plantar fascia is a cord-like structure that runs from the heel to the front part of the foot. Partial or complete plantar fascia release may be done.
Prevention
Maintain a healthy weight, Use insoles to support your arches, Limit how often you wear high heels, Use proper shoes, especially when exercising to evenly distribute weight through your foot.
Stretching Exercises
Calf Raises. Strengthens the tendons in your heels and calf muscles, which support your arch. Raise up on the balls of your feet as high as possible. Slowly lower down. Do three sets of 10 reps. Progress to doing the raises on stairs (with heels hanging off), and then to single-leg raises. Step Stretch. Improves flexibility in your Achilles tendon and calf-when these areas become tight, the arch gets painfully overloaded. Stand at the edge of a step, toes on step, heels hanging off. Lower your heels down, past the step, then raise back up to the start position. Do three sets of 10 reps. Doming. Works the arch muscles and the tibialis posterior (in the calf and foot) to control excess pronation. While standing, press your toes downward into the ground while keeping the heel planted, so that your foot forms an arch (or dome). Release, and do three sets of 10 reps on each foot. Toe Spread and Squeeze. Targets the interossei muscles of the foot, which support the arch. While sitting, loop a small resistance band around your toes. Spread toes; release. Then place a toe separator (used at nail salons) in between toes. Squeeze toes in; release. Do three sets of 10 reps of each exercise on both feet. Towel Curls. Works the toe-flexor muscles that run along your arch to increase overall foot strength. Lay a small hand towel on the floor, and place one foot on the towel. Using just your toes, scrunch the towel toward you, hold, then slowly push the towel away from you back to start position. Do three sets of 10 reps on each foot.