Small changes in the structure of your foot can lead to problems down the road. The bones of your feet are arranged in a highly specific manner; changes in that arrangement often affect multiple parts of the foot. According to Mayo Clinic, a flat foot is when the arch on the bottom-inside portion of your foot is flat against the floor when you stand up.
Foot Anatomy
The foot is an intricately designed piece of machinery. The carefully shaped bones are held together in a stable, though flexible, device, which is ideal for walking. The arch of your foot is crucial for proper gait; when you lose, or if you were born without, an arch in your foot, there are changes that may occur, affecting your ankle as well as other parts of the foot.
Pathology of Flat Feet
Current theories regarding the pathology of flat feet, also knowns as pes planus, are based on the importance of correct bone positioning within the foot. When tendons responsible for holding the foot in an arch position are weak, the arch disappears and the biomechanics of the entire foot are necessarily altered.
Consequences of Flat Feet
There is controversy within the medical community regarding the pathology of flat feet, according to the article, “The Natural History and Pathophysiology of Flexible Flatfoot,” from Loyola Medical Center. The debate is based on the fact that not all people with flat feet have negative symptoms, or will ever even develop them. While many children have flat feet early in life, these conditions have been shown to self-correct as the child ages. This type of evidence sways some doctors toward conservative management of flat feet. However, some cases progress to severe tendinopathies, or tendon disease, and other foot deformities. This type of evidence pulls doctors toward more aggressive therapy earlier in life.
Therapy
Conservative treatments include orthotic devices and stretching exercises. Foot inserts are designed to create the arch you are missing. By providing the support, these inserts restore the foot to its natural position, allowing biomechanical forces to distribute in the appropriate way. Stretching exercise are used to create stability in other muscles of the foot and ankle. The muscles responsible for generating your arch are weak or nonfunctional, this puts more force on the other muscles in the area. If these other muscles are strong enough, they will be able to handle the burden placed upon them. You have to prepare them for this challenge, otherwise they will become sore and inflamed from overuse.
Surgery
According to the book “Current Diagnosis and Treatment in Orthopedics,” symptomatic flatfoot may be surgically managed by lengthening the Achilles tendon. This tendon, which runs from your heel up into your calf, may help correct the abnormalities in foot structure and function. These procedures should be performed as late as possible to avoid disturbing normal bone growth.