Flexible flatfeet are considered normal in young children because babies are not born with a normal arch. The arch may not form fully until sometime between ages 7 and 10. Even in adulthood, 15% to 25% of people have flexible flatfeet. Most of these people never develop symptoms. In many adults who have had flexible flatfeet since childhood, the missing arch is an inherited condition related to a general looseness of ligaments. These people usually have extremely flexible, very mobile joints throughout the body, not only in the feet. Flatfeet also can develop during adulthood. Causes include joint disease, such as rheumatoid arthritis, and disorders of nerve function (neuropathy).
If the feet are exposed to damp conditions for prolonged periods, you can develop Trench Foot. Most commonly associated with World War One, it now tends to be seen in builders, hikers or festival goers. Trench foot causing numbness and bottom of foot pain. With Trench Foot, the sole of the foot turns a white/grey colour and you may develop pins and needles or numbness. Other symptoms include pain in bottom of foot and swelling. If left untreated, you can develop blisters and permanent nerve damage which can lead to the need for amputation. Treatment and prevention aim to reduce the dampness around the foot and ensure good foot hygiene. Slowly rewarming the feet and using special products in a foot bath really helps reduce the damage and foot arch pain from Trench Foot.
Most flat feet do not cause pain or other problems. Children may have foot pain, ankle pain, or lower leg pain. They should be evaluated by a health care provider if this occurs. Symptoms in adults may include tired or achy feet after long periods of standing or playing sports.
A patient is asked to step with full body weight on the symptomatic foot, keeping the unaffected foot off the ground. The patient is then instructed to "raise up on the tip toes" of the affected foot. If the posterior tibial tendon has been attenuated or ruptured, the patient will be unable to lift the heel off the floor and rise onto the toes. In less severe cases, the patient will be able to rise on the toes, but the heel will not be noted to invert as it normally does when we rise onto the toes. X-rays can be helpful but are not diagnostic of the adult acquired flatfoot. Both feet, the symptomatic and asymptomatic - will demonstrate a flatfoot deformity on x-ray. Careful observation may show a greater severity of deformity on the affected side.
Non Surgical Treatment
Standing and walking barefoot are two easy ways to start treating flat feet naturally. Balancing on one leg and light jumping while barefoot will further progress the normal development of the foot; and finally running while barefoot is the ultimate way to naturally and most effectively strengthen the muscles, tendons, and ligaments of the lower leg and foot. Of course a child running barefoot is much less likely to have FFF than a shod child. Sometimes other interventions and therapies are needed for flat feet. In the case of RFF, which is much less common than FFF, treating the cause of the problem is recommended. If the RFF is causing problems (such as pain) then in some cases, depending on the individual, surgery or a supportive orthotic may be beneficial.
In cases where cast immobilization, orthoses and shoe therapy have failed, surgery is the next alternative. The goal of surgery and non-surgical treatment is to eliminate pain, stop progression of the deformity and improve mobility of the patient. Opinions vary as to the best surgical treatment for adult acquired flatfoot. Procedures commonly used to correct the condition include tendon debridement, tendon transfers, osteotomies (cutting and repositioning of bone) and joint fusions.
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.