When Flat Feet are a Pain
by Gemma Gerb (Guest Author)
Elizabeth, a 40 year old woman with mild congenital cerebral palsy had been lucky enough to spend the majority of her adult life free from any disability related discomfort. As she edged towards middle age, this began to change. She developed pains in her feet and a swollen ankle that felt like a sprain which kept reoccuring. Sometimes the pain was so bad that she had to crawl around the house and cook meals sitting down.
Pes Planovalgus
Her problem was Pes Planovalgus, or flat feet, causing her foot to roll over and sprain her ankle repeatedly. Flat feet are common in people with cerebral palsy and other neurological conditions because weak muscle control and poor posture can lead to a collapse of the foot arches.
However, you don't have to have a disability to have flat feet. They can be inherited from a parent, caused by wearing high heels and they are more common in people who have diabetes or high blood pressure. People who are overweight are also prone to flat feet due to greater weight loading and its affect on muscles. Half of all people with rheumatoid arthritis have flat feet.
In most cases it doesn't cause any discomfort and if that's the case, no treatment is required. Sometimes, though, feet without arches will cause pain in the feet, swelling and repetitive sprain injuries to the mid-foot (medial arch sprain). Hip pain or pain in the knees can also occur.
However, you don't have to have a disability to have flat feet. They can be inherited from a parent, caused by wearing high heels and they are more common in people who have diabetes or high blood pressure. People who are overweight are also prone to flat feet due to greater weight loading and its affect on muscles. Half of all people with rheumatoid arthritis have flat feet.
In most cases it doesn't cause any discomfort and if that's the case, no treatment is required. Sometimes, though, feet without arches will cause pain in the feet, swelling and repetitive sprain injuries to the mid-foot (medial arch sprain). Hip pain or pain in the knees can also occur.
Options for Treating Pain
You'll be happy to know that usually surgery isn't necessary if the patient responds to less intrusive measures. There are no cut solutions to Pes Planovalgus.
Physical Therapy Exercises - Exercises designed to encourage the correct positioning of the toes. In very mild cases, regular exercising that keeps the toes in position may reduce strain on your feet. Stretching your calf muscles might also give you more flexibility.
Toe Spacers - Toe spacers keep your toes separated in the correct position. By aligning the toes, balance will improve and muscles in the feet and lower legs to ease pain and bring back function.
Elevation and Ice - This sounds simple but old fashioned elevation and icing will help to ease the pain and swelling of a medial arch sprain.
Anti-inflammatory Painkillers - If you don't have a history of stomach ulcers or other inflammatory digestive disorders, you may be able to take anti-inflammatory painkillers to cope with any immediate pain.
Massage - Therapeutic massage of the ankles, feet and legs can provide relief from pain as well as reducing inflammation and enhancing blood flow to the area.
Support Bandages and Braces - When attempting to walk, the foot should be supported with an arch support bandage so you can move around while allowing the area to heal. There are heavier duty braces available but when wearing these it's important to take them off regularly. Muscles and tendons that never have to work on their own become weak and in the long term this could make the problem worse.
Orthopedic Shoes and Orthotics - For daily support that doesn't weaken your foot, a cast can be taken of it and custom made supportive shoes designed for your specific feet, with built in arch supports, or arch supports for your regular shoe gear.
Surgery: A Last Resort
If flat feet or trauma has caused a severe medial arch sprain, the affected ligament may not be able to support your bones as usual so surgery may be required to hold them together. It might also be suggested if you have failed to respond to more conservative measures.
A small cut is made on the top of the foot over the unstable bones and metal wires or screws are attached to hold them in the correct position. Afterwards weight has to kept off the operated foot and you'll be placed in a cast or a splint for up to six months while you recover, so it isn't a quick fix and should be looked at as a last resort when other options would not or did not help.
Flat foot surgical reconstruction can also be done to re-fashion an arch and repair and support damaged ligaments to reduce pain and restore the full ability to walk. There are a variety of procedures depending upon the complication that flat foot has caused, for example, if the Achilles's tendon is too tight, this can be lengthened to release pressure.
For more information about flat feet, medial arch sprains or any other aspect of foot healthcare, contact Doctor Blake for his professional and approachable advice. For surgical advice, see his partner, Dr Remy Ardizzone. You do not have to suffer from flat feet.
