From the Research
Causes of Flatfoot (Pes Planus)
- A foot injury can cause the arch to collapse, resulting in flatfoot (pes planus) due to an imbalance in the forces that tend to flatten the arch and those that support the arch 1.
- Weakness of the muscular, ligamentous, or bony arch supporting structures can lead to collapse of the arch, resulting in flatfoot 1.
- The main factors that contribute to an acquired flat foot deformity are excessive tension in the triceps surae, obesity, PTT dysfunction, or ligamentous laxity in the spring ligament, plantar fascia, or other supporting plantar ligaments 1.
Relationship Between Foot Injuries and Flatfoot
- Posterior tibial tendon insufficiency (PTTI) is often misdiagnosed as a chronic ankle sprain, osteoarthritis, or collapsed arch as a result of aging or obesity, and it leaves the patient debilitated 2.
- The posterior tibial muscle is the key dynamic support of the medial longitudinal arch of the foot, and when it fails, the arch slowly collapses, resulting in painful acquired pes planovalgus abductus et supinatus 2.
Characteristics of Flatfoot
- Flatfoot is a foot condition caused by the collapse of the medial arch of the foot, and it can result in problems such as severe pain, swelling, abnormal gait, and difficulty walking 3.
- Flexible pes planus is defined as a normal arch during non-weight-bearing activity or tiptoeing, with a flattening arch on standing, while rigid pes planus is characterized by a stiff and collapsed arch with or without weight bearing 4.
Treatment and Management of Flatfoot
- Treatment of the adult acquired flat foot is often difficult, and the clinician should remember the biomechanics of the normal arch and respond with a treatment that strengthens the supporting structures of the arch or weakens the arch-flattening effects on the arch 1.
- Wearing an arch-support insole can provide benefits in shortened stance time and generation of propulsion force to the big toe while walking on uphill and level surfaces and to the metatarsals 2-4 while walking on the level surface 5.