Pes Planus
About
Pes planus, often called flat feet, is very common. Some research estimates that one quarter of the population has flat feet. In fact, we're all born with flat feet and only as we age, somewhere between age 3 and 10, do our feet usually develop an arch.
Some people never grow arches, however, and others experience fallen arches, which occurs when the arch develops but later collapses. It's not difficult to know if you have either of these problems. While seated, with your feet flat on the ground, bend down and look at the inside of either foot. If you don't have the condition, you should see a raised area in the middle. If the whole foot is relatively flat on ground, however, and there's little or no noticeable rise where the arch should be, you probably have flat feet.
While recognizing flat feet might be easy, predicting its long-term effects is more difficult. Over time, flat feet can cause pain, but it's possible for people to have the condition and never feel any discomfort. For people who do develop pain, it usually occurs in the feet and knees, and possibly in the hips and lower back. The discomfort or irritation in any one of these areas can vary immensely. The pain in the foot, for example, can feel sharp, dull, bruised, achy or tight.
Besides genetic causes, which prevent people from ever developing arches, there are a number of factors that can cause flat feet or predispose people to the condition. Structural abnormalities in the feet such as over-pronation, which involves the foot rolling too far inward, are one cause of the condition. Activity level also contributes. People who are regularly involved in athletic activities or work at a job that requires them to remain standing for extended periods are more likely to have flat feet and experience pain from the condition, as it makes them more susceptible to soreness in the feet, knees, hips or low back. Those who aren't active, on the other hand, may have weak muscles that are less capable of supporting the arches, which therefore allows the feet to weaken.
Age and weight also play a role in the condition's development. Middle-aged people who have been working on their feet for years often experience flat feet, as do overweight people who are placing added stress on their feet and legs. Both prolonged standing and excess weight can put stress on the body that forces the legs and feet to do more work than they're capable of.
If you have flat feet, you should see your healthcare practitioner as soon as possible regardless of how much pain the condition's causing. Your healthcare practitioner can determine a plan of management that can ease pain or prevent symptoms from developing.
Anatomy
If you consider that feet bear the body's weight during walking and standing, you will probably appreciate the necessity of each foot structure, including the arch, and how conditions like pes planus (flat feet) can lead to pain and dysfunction throughout the whole body.
The arch is the curved part of the foot that runs from the ball of the foot down to the beginning of the heel. It comprises four layers of muscle, several supporting and anchoring tendons, several ligaments and the plantar fascia, which is a smooth, flat connective tissue that runs from the front of your heel bone to the ball of your foot.
The arch helps feet in a number of ways, but has three main functions. First, it allows feet to absorb the weight and pressure of walking. With proper arches, feet are flexible shock absorbers. During walking, the arch flattens to absorb body weight, which helps to spread weight evenly through the foot.
Second, it allows for a process called toe-off. When you walk, five bones in the forefoot called metatarsals must become rigid to provide a stable lever from which you then push off. If you touch the top of your foot you can feel these five bones, which spread across the top of the foot like fingers. Without proper arches, there's little support for the metatarsals and they are unable to maintain the rigid position necessary for toe-off.
Third, the arch acts as a stopping mechanism to prevent feet from rolling inward. Feet naturally rotate inward with each step, and the structure of the arch prevents them from rolling too far.
Since arches are necessary for so many important functions, it's easy to see how a lack of arches can lead to problems and pain. Without arches, feet no longer act as shock absorbers, which can lead to inflammation of the fascia because it's not capable of absorbing additional shock. This inflammatory condition is called plantar fasciitis, and it commonly occurs in people who have flat feet.
Flat feet also make toe-off more difficult, as the metatarsals can't become rigid without an arch. This can lead to problems in the way people walk and possibly lead to damage in the knees, hips and even in the low back.
Without arches, feet also tend to over-pronate (roll too far inward), since there are no arches to prevent this. Over-pronation can force the knees beyond their normal range of motion, which can affect the knee joint's function and lead to long-term damage.
As mentioned in the About section, there are a number of things that can lead to flat feet, and possibly to some of the aforementioned problems. It's also possible that you could have the condition and feel no pain, but that's no reason not to seek chiropractic care. Your chiropractor can offer conservative management for flat feet, which can prevent future problems from developing.
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