Flat Feet (Pes Planus)
Flat feet, or flatfoot disorder, is a foot deformity characterized by a low or collapsed medial longitudinal arch, which impairs the foot’s shock absorption and weight-bearing functions.
I. Core Definition & Self-Test
Definition:
When standing, the medial longitudinal arch collapses, the sole becomes flat, often accompanied by heel valgus and forefoot abduction.
Simple Self-Test:
Wet your foot and step on a piece of paper.
- Normal foot: a clear “gap” in the footprint.
- Flat foot: the gap disappears, and the footprint is almost full.
Key Classification:
Flexible (Physiological) Flat FootThe arch disappears under weight but reappears when standing on tiptoes or non-weight-bearing.
Common in children, usually pain-free.
Rigid (Pathological) Flat FootThe arch remains flat whether weight-bearing or not.
Often accompanied by pain and limited mobility.
II. Main Causes
Congenital
- Genetic factors (higher risk if parents have flat feet)
- Congenital abnormalities of foot bones or ligaments (e.g., tarsal coalition)
- Congenital muscle or tendon laxity
Acquired
- Long-term standing, walking, obesity, or excessive loading leading to arch strain
- Foot trauma, rheumatoid arthritis, diabetes, neuropathy, etc., damaging arch structure
- Improper footwear (long-term use of flat, soft-soled shoes)
III. Common Symptoms & Complications
- Pain or soreness on the medial sole, worsened by prolonged standing or walking
- Easy foot fatigue and reduced mobility
- Heel valgus, walking with an outward gait, instability
- Swelling near the navicular bone, tightness or cramping in calf muscles
Long-term risks:
- Foot arthritis, stress fractures of metatarsals
- Abnormal lower-extremity alignment, leading to compensatory knee, hip, and lower back pain
- Reduced athletic performance, increased risk of ankle sprains
IV. Stage-Based Intervention
Children (3–14 years: golden correction period)
- 3–7 years: Observation + muscle training (tiptoe walking, skipping rope, barefoot walking on sand)
- 8–14 years: Custom orthotic insoles + rehabilitation; minimally invasive surgery in severe cases
Adolescents & Adults
Conservative Treatment (First Choice)
- Custom orthotic insoles: support the arch, improve alignment, relieve pain
- Proper shoes: good arch support, torsion-resistant soles; avoid flat or soft shoes
- Rehabilitation: strengthen calves and foot muscles (e.g., calf raises, towel-gripping exercises)
- Weight control & rest: reduce prolonged standing, long-distance running, jumping
Surgical Treatment
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