Most of us have a laid back attitude when it comes to painting a picture about ourselves. The reason for the arch of the sole of the foot is that the tendons of your sole of the foot and the sole of your foot stick together to create space at the bottom of your foot. If those tendons fail, the arch will disappear. This biomechanical event removes the soles of the feet and legs and can lead to a long list of stress injuries that may cause you to limp or even get stuck in bed.
Flat feet are a common cause of pain in the soles of the feet, ankles, legs and back due to insufficient support for body weight when standing or moving.
Most foot abnormalities can be easily and effectively treated at the Omid Comprehensive Rehabilitation Center. The treatment for your foot deformity that is best for you depends on the extent of your deformity and your complaint. Mild cases can usually be effectively treated with shoe inserts and leg exercises. Surgical intervention is required only in severe cases.
How does flat feet happen?
Plantar fasciitis is a natural transitional stage during childhood development.
Underfoot children are thicker than adults.
The most common cause of flat feet in children and adults is loosening of the capsular ligaments, which is associated with muscle weakness.
If the foot has poor mobility, it may be due to abnormal connections between the tarsal bones.
In rare cases, separate bones are incorrectly placed next to each other
Occasionally, after the age of 40, the prevalence of flat feet increases exponentially, or the flat feet that already exist become significantly worse.
Potential symptoms of flat feet
In most cases, flat feet are mild and have no symptoms and do not require further treatment. Increased pain in the inner ankle in combination with a flat foot may indicate excessive stretching of the tibial dorsal tendon. If the heel is constantly tilted outward, more pain may occur in this area.
Complications of flat feet
The effects of curved soles of the feet are not limited to leaving a full footprint in the beach sand. It can also cause other injuries to your soles and feet due to unwanted or new pressure on your ankle, tibia or patella.
Here are some common injuries or strains caused by flat feet.
Chronic muscle strain
The soles of the feet are not as skilled at maintaining the stability of the body as the feet that have a natural arch. As a result, people with plantar fasciitis are exposed to chronic muscle strain. Because the muscles of the body are forced to compensate for the lack of leg stability. Although your body may be able to adapt to the lack of support for your legs during daily activities, when you increase your activity level even slightly, it can cause severe muscle pain and pressure.
Leg and back pain
Normal legs are designed to support the entire lower body when standing or walking. A flat foot can not provide this foundation for a healthy body. As the arch of the foot falls to the ground, the lower legs rotate inward. This inward rotation can affect the entire leg, including the buttocks, and lead to long-term leg and back pain.
Musculoskeletal problems
Flat feet are one of the main causes of pain and general musculoskeletal problems. Balancing your body starts with your legs. When the legs are not properly supported, the risk of joint problems due to poor posture and abnormal gait may increase. People with flat feet may have injuries to the soles of the feet, ankles, knees, or sides.
Knee pain (patellofemoral pain syndrome)
When the flatness of your foot is high, it causes a rotational change in the way your ankle moves. These changes travel to your knee, which can lead to patellofemoral pain syndrome or knee pain.
You will notice pain because the area behind the patella (where the patella meets your femur) hurts. In most cases, the pain is gradual. The pain starts as an annoying sensation but gets so severe that it becomes painful to sit, stand, walk and run.
You need physical therapy to relieve both pain and sagging arches (assuming these are the main cause of your knee pain).
Plantar fasciitis is a complication of flat feet
Plantar fasciitis is a common injury that causes crippling pain in the heel and sometimes in your arch. This problem is especially common among runners and climbers, as well as people who stand for eight hours a day.
Where does your foot hurt when you have plantar fasciitis? The cause of this problem is inflammation of the plantar fascia. The plantar fascia attaches your heel to your toes and passes through the bottom of your foot.
Stretching due to flat feet on other parts of your foot can cause plantar fasciitis.
Physicians often treat plantar fasciitis with physiotherapy, night splints, or custom orthoses (supporting the arch of the foot). These interventions distribute the pressure on your feet properly to alleviate the cause of the inflammation.
Achilles tendonitis
When you have flat feet, the range of motion in the middle of the foot increases, and this is abnormal. To adapt to this condition, your Achilles tendon must work harder, which can lead to Achilles tendon strain and inflammation.
Symptoms of tendonitis include stiff leg muscles, difficulty achieving full range of motion when the foot bends, or swelling in the heel.
Symptoms of tendonitis include stiff leg muscles, difficulty achieving full range of motion when the foot bends, or swelling in the heel.
To treat Achilles tendonitis caused by flat feet, doctors must both treat excessive perineum and use rest, ice, compression, and elevation techniques. You may also need to reduce your physical activity and use stretching techniques for the lower legs.
Shin splint (internal tibial stress syndrome) is a complication of flat feet
Excessive pronation due to flat feet can cause double or altered stress on the lower leg. This affects the inside of your tibia, which can lead to a splint. Shin splints cause vague pain in the front of the leg, around the bone (or muscle).
Not all people who struggle with flat feet get shin splints. This problem is often associated with excessive pronation and excessive exercise.
However, you should adjust your activity level according to the pain you are experiencing. If your shin splint gets worse during exercise, or you have pain all the time, then you should stop all activities.
Treatment of shin splints due to flat feet requires treatment of fallen tendons as well as ice and elevation (and potentially anti-inflammatory).
Posterior tibialis tendinopathy
There is a tendon that connects the inside of the leg to the back of the ankle bone and joins the middle of your foot. You can experience posterior tibialis tendonitis thanks to the stress of the flat foot.
Tendonitis (inflammation)
Tendinosis (degenerative tendon)
Tenosynovitis (inflamed tendon sheath)
Tendon rupture
Other reasons include over-exercising, changing exercise levels, wearing high heels (walking on toes), and hill climbing.
If you have posterior tibialis tendinopathy, you will have pain when walking, running or jumping. The most well-known feature of tendinopathy is its accompanying lameness.
To combat inflammation, you should reduce your activity and use the RICE method (rest, ice, compression, altitude). When flat feet are the cause of these problems, you should remove them to reduce the pressure on your posterior tibialis bone.
Recognize flat feet
If the deformity has caused you pain and symptoms, a clinical examination is needed. In this examination, our specialists first examine the condition of your foot under full stretching. When your heel is bent towards the outside of the foot, it is a sign of flat feet. If it is tilted inwards, it indicates a high arc. If the longitudinal arch rises well when walking on the toes, the deformation is generally harmless. If the longitudinal arch no longer rises normally or you can no longer stand on your fingertips, this is a sign of a posterior tibial tendon disorder.
During the clinical examination, doctors also check the stability of the ankle joint, especially the external ligaments. Imaging techniques, such as X-ray examinations, are performed for accurate diagnosis.
X-ray images show the position of the bones
Doctors will first take x-rays of you in three cases. They also take pictures of the ankle joint under pressure and pivotal images of your heel. All of these images show the position of your bones relative to each other. This allows physicians to determine abnormal bone formation, misalignment of bones, and signs of wear and tear on the joints. X-ray images under stress show the need for correction.
MRI to evaluate tendons, ligaments and cartilage
Using magnetic resonance imaging (MRI), doctors can safely assess whether the posterior tibial tendon is damaged in the case of a flat foot or the peroneal tendon if the arch is high. Information about cartilage, especially in the upper ankle joint, is important for planning the best possible treatment strategy.
Additional examination in case of uncertainty
Doctors can also analyze the pressure distribution on your foot while moving using a dynamic pressure measuring system. This test will provide more evidence of the cause of your problem.
treatment
Plantar fasciitis in adults often does not require any treatment. People with persistent or severe symptoms may benefit from medical arch and gymnastic leg supports. Conservative therapies such as nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, and orthoses or braces are tested before surgery.
Treatment of flat feet with shoe insoles and orthoses
Special insoles can be used to treat flat feet and long, soft arches. Insoles that support the longitudinal arch of the foot are used to flatten the sole of the foot. These insoles activate the muscles that support the longitudinal arch. The more flexible the foot, the better the chance of successful treatment.
Surgical treatment of flat feet
In young patients, we can correct the deformity by using the "distance" between the heel bone and the ankle. After two to three years, the problem goes away. For this treatment, all tendons must function normally.
If there is a bony bridge between the separate bones of the tarsus, we can solve this problem through surgery. However, if you have never had normal movement in the injured joints, you may still have symptoms. If the normal joint is not formed at all, under certain conditions, your symptoms will be reduced only through joint fusion.
Our specialists correct deformity through flatfoot surgery and also restore the normal function of the posterior tibial tendon by suturing one of the tendons that bend the toes and strengthening the posterior tibial tendon. We repair bone abnormalities by correcting the position of the heel bone. Additional surgical procedures, such as correction of the mid-leg position or Achilles tendon strain, may be necessary depending on the deformity of each individual.
If the deformity has been present for many years, the lower ankle joint may be damaged. If osteoarthritis has occurred in the lower ankle joint, the deformity and discomfort can only be treated by strengthening the lower ankle joint. In this case, the goal is to start treatment as soon as possible, so there is no need for augmentation surgery.