Flatfoot – causes, complaints & therapy

A countersunk foot is the flattened longitudinal arch of one or both feet. The area between the ball of the forefoot and the heel is called the longitudinal arch, usually this region of the foot is not loaded.

The natural structure of the foot provides that two-thirds of the body weight lies on the ball during load, the other third is carried by the heel. The longitudinal arch serves as a shock absorber under load, it is supported by ligaments and muscles.

Flatfeet are characterized by the fact that the bones protrude on the inner side of the foot. When viewed from behind, it is noticeable that the heels of the countersunk foot point inwards. If left untreated, a flatfoot can develop into a pronounced flatfoot, in which the vault is completely sunken and lies on the floor under load.

Causes

The causes of feet are different, in many cases a weakness of the muscles is responsible for the malposition. Another possible reason is ligament weakness, which can develop over the course of life due to excessive stress.In overweight people, the load on the foot is generally greatly increased, which can lead to the formation of flattening feet. The reduction of weight in this case can lead to the complete regression of symptoms.

Very rarely, children are already born with a congenital malformation in the form of flat feet, since the foot shape in children is different anyway, the diagnosis is usually made only in adulthood.

In some diseases, paralysis of the muscles occurs, although the muscles of the foot are affected, it can lead to the formation of flattering feet for this reason.

Flat feet develop in most people only in the course of life, overweight and incorrect load by unsuitable shoes are the main reasons for the change in foot shape. Not infrequently, several combined causes are responsible for the formation of the plumes.

Symptoms and course

Flatfeet can develop as early as childhood, but are usually only diagnosed in adults. The first complaints are usually stress-related pain, which disappears quickly at rest. The typical appearance of flatfoot feet is usually not noticed by those affected, since the view from behind is decisive for the diagnosis.

While the flattered feet cause little discomfort at the beginning of the lowering, the symptoms increase in the course of the malformation. As soon as the foot has to carry the body weight, the malposition can cause pain, which becomes more and more severe in the course of the disease. If the flatfoot is not treated at this time, a complete flat foot may develop. The overloaded arch of the foot sinks further and further untreated until the entire foot rests on the floor. As a result of this malposition, pain in the knees and intervertebral disc can occur under load. Flat feet should be treated as soon as possible to prevent a painful and unpleasant course for the patient.

Diagnosis

The diagnosis of the flatfoot can usually be made at the first glance of the doctor’s foot. The characteristic appearance of the malformation is clear, an experienced physician therefore sees the sunken arch of the foot immediately. If there are any doubts about the diagnosis, an X-ray can provide absolute clarity. This examination is useful anyway to find out the extent of the deformity.

There are some test procedures that the doctor uses as part of the first examination to confirm the suspected diagnosis of flatfoot. If the patient stands on his tiptoes, the arch of the foot is straightened up if it is a lowered foot. A footprint can also provide further information about the type and extent of the deformity. In a healthy foot, the arch is not visible on the impression, but in the sunken foot the sunken arch is visible on the impression.

In order to rule out another malposition or injury to the foot, the doctor will also check the mobility of the ankles. In the case of flat feet, the joints are not affected and the foot can be moved completely normally. If the diagnosis of flat foot is established, only further examinations are arranged if the suspicion points to another malposition, which can occur in combination with the flat foot.

treatment and therapy

Flat feet should be treated as soon as possible, otherwise a fully developed flat foot may occur. While in fallen arches only a part of the arch of the foot has dropped and touches the floor under load, in flat feet the entire footbed lies on the floor. The treatment of flat feet depends on the cause, weakened ligaments and muscles can be rebuilt and strengthened with the help of physiotherapy. An often underestimated treatment method for flat feet is walking barefoot. Due to the direct contact between foot and ground, the muscles are stressed and trained in this way.

In the case of pronounced flat feet, walking barefoot can lead to pain, which is why there are special physiotherapists with whom those affected can complete a so-called barefoot course. But even if it is not possible to go barefoot, there are ways to strengthen the foot muscles in everyday life.

Shoes with maximum freedom of movement such as thong sandals, moccasins or special barefoot shoes are ideal for flat feet. If the flat feet cause stress-related pain, special insoles can alleviate these symptoms. The malposition can be corrected by individually adapting the insoles to the foot, so that there is no further damage to the intervertebral disc or knees.

So-called gel insoles are used as a therapeutic measure to build muscle in the feet. These are insoles for the footbed, which are filled with a fluid-like liquid. As an alternative, inserts made of plastic, which are made according to a plaster cast of the affected person, have proven themselves.

A lot can also be done in terms of self-treatment to alleviate the symptoms of flat feet. Toe gymnastics like those done by infants in their crib helps to strengthen the muscles. Foot baths relieve the pain, and you should always take a break from heavy exertion.

Prevention

There are several ways to prevent flat feet. The deformity is often only acquired later in life through bad habits or muscle atrophy. Regular training is required to prevent muscle loss in the foot area. No special methods are required for this, simply walking barefoot is considered by experts to be the best way to strengthen the ligaments and foot muscles. Even small children should learn to move without shoes if possible. Malpositions such as flat feet can already be acquired in childhood if the wrong or too tight shoes put excessive strain on the feet.