From the Guidelines
Yes, pes planus can be exacerbated by knee, ankle, and hip problems. The human musculoskeletal system functions as an interconnected chain, where dysfunction in one joint can affect alignment and mechanics in others 1. When knee issues like osteoarthritis or ligament injuries occur, they often alter gait patterns and weight distribution, placing additional stress on the foot arch. Similarly, ankle problems such as sprains or instability can compromise the foot's natural supportive structures, worsening flat feet. Hip pathologies, including arthritis or muscle imbalances, change pelvic alignment and lower limb biomechanics, which transfers abnormal forces to the feet.
This bidirectional relationship means that flat feet can also contribute to problems in these joints, creating a potential cycle of dysfunction. Management typically involves addressing both the primary joint issue and providing appropriate foot support through orthotics, proper footwear, targeted exercises to strengthen foot muscles, and in some cases, physical therapy to improve overall lower limb biomechanics and alignment 1. Key considerations include:
- Individualized management plans that address the person's specific needs and goals
- Education on proper footwear, including the use of comfortable and appropriate shoes
- Exercise regimens that strengthen the muscles around the affected joints, including the quadriceps and proximal hip girdle muscles
- Weight management strategies to reduce the stress on the joints
- The use of walking aids, assistive technology, and adaptations at home and/or at work to reduce pain and increase participation.
In terms of specific interventions, prefabricated foot orthoses can be prescribed to those who respond favourably to treatment direction tests and be customized for comfort by modifying density and geometry 1. Additionally, movement/running retraining can be considered in those with symptoms reasoned to be associated with assessment findings aligning with the intervention. Overall, a comprehensive approach that addresses the interconnected nature of the musculoskeletal system is essential for effective management of pes planus and related knee, ankle, and hip problems.
From the Research
Pes Planus and Lower Limb Problems
- Pes planus, also known as flatfoot, can be affected by various lower limb problems, including knee, ankle, and hip issues 2, 3, 4, 5, 6.
- The condition can lead to alterations in lower limb biomechanics, potentially contributing to pain and injury in the knee, ankle, and hip 3, 6.
Association with Knee Problems
- Research suggests that pes planus can be associated with medial compartment knee osteoarthritis (OA) and can impact knee function 6.
- A study found that patients with more severe flat feet had significantly lower knee function scores and greater pain, indicating a strong association between flat foot severity and knee OA 6.
Impact on Ankle and Hip
- While the provided studies do not directly address the impact of pes planus on ankle and hip problems, it is known that alterations in lower limb biomechanics can affect the entire lower limb, including the ankle and hip 3, 4, 5.
- Further research is needed to fully understand the relationship between pes planus and ankle and hip problems.
Treatment and Management
- Treatment for pes planus often involves conservative management, such as orthotics and physical therapy, although surgical intervention may be necessary in some cases 2, 4, 5.
- Early intervention and orthotic management may be beneficial in mitigating the progression and severity of knee OA in patients with pes planus 6.