Flat Feet - Fallen Arches - Flat-Footed Walking Problems

Flat Feet and Flat-Footed Walking Can Cause Pain

Portrait of Young Woman's Feet Relaxing in Field
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Walking flat-footed is a walking mistake that can be corrected, while having flat feet or fallen arches are conditions that may cause you pain. They have different solutions.

Painful Flatfoot and Fallen Arches - When Flat Feet are a Problem

Do you have fallen arches or flatfoot that cause you enough pain that you avoid walking and exercise? The American College of Foot and Ankle Surgeons (ACFAS) estimates that 5% of adults have this problem.

They published clinical practice guidelines in 2005 to assist physicians in treating flatfoot when it is painful and limits your healthy lifestyle. "For many adults, flat feet cause nagging foot pain that gets worse over time. It's tough to be active, shed excess pounds and maintain a healthy lifestyle if your feet hurt constantly," said Kris DiNucci, DPM, FACFAS, in a press release. A study in 2011 found that older adults with flat feet had 1.3 times the risk of knee pain and 1.4 times the risk of knee cartilage damage.

Flexible Flatfoot

If your foot is flat when you are standing but it rebounds to a normal arch height when you sit, this is known as flexible flatfoot. When it is painful and medical treatment is sought, the ACFAS guideline recommends first using non-invasive treatments including changing or limiting activity and doing stretching exercises. Stretching the Achilles tendon, which attaches to the calf muscle, is thought to be good for flatfoot.

They may prescribe non-steroidal anti-inflammatory medication and custom shoe orthotics. After trying those tactics and the patient still has foot pain, they may resort to surgical interventions.

Shoes for Flatfoot Walkers

People with flatfoot often overpronate and one solution is motion control shoes that limit the excessive roll of the ankle during walking or running.

Not everyone with flat feet overpronates, so it is something you need to have checked in order to get the right shoes. If you are prescribed orthotics, you will want to look for shoes that have a removable insole and enough volume so you can comfortably wear it in your walking shoes.

Adult-Acquired Flatfoot - Fallen Arches

Adult-acquired flatfoot is a more serious condition that is often caused by posterior tibial tendon dysfunction (PTTD). This tendon is supposed to support the arch, but it may weaken. When it fails, it leads to a rigid flat foot. While the arch rebounds in flexible flatfoot, in this condition it stays flat even when you aren't standing on it. You may lose your range of motion in the foot and ankle and have pain in your arch. The ACFAS clinical guideline recommends that flatfoot caused by PTTD can be treated with custom shoe orthotics, soft casts, walking boots, physical therapy and non-steroidal anti-inflammatory medications. If there is no relief or the condition worsens, then the patient may be referred to surgery.

Walking Flat-Footed

People with normal arches or flat feet can find themselves walking flat-footed. Their feet slap down with each step from the ankle rather than striking with the heel and rolling through a step, pushing off with the toe. Instead their heel hits the ground and flattens out with a slap. Or, they land flat-footed already at mid-sole with no heel strike. This can lead to shin pain.

Flat-footed walking is usually caused by having shoes that are too stiff. Unfortunately, many shoes marketed to walkers have stiff soles, as do many comfort shoes and boots. Your foot simply can't roll through a step as nature intended. The cure is to buy flexible shoes that bend at the ball of the foot.

Sources:
Press Release "New clinical practice guideline published to treat flat feet in adults." American College of Foot and Ankle Surgeons, March 5, 2005

Gross KD, Felson DT, Niu J, Hunter DJ, Guermazi A, Roemer FW, Dufour AB, Gensure RH, Hannan MT. "Association of flat feet with knee pain and cartilage damage in older adults." Arthritis Care Res (Hoboken). 2011 Jul;63(7):937-44. doi: 10.1002/acr.20431.

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