Zulema Napoletano

Dealing With Feet Difficulties

Tips To Take Care Of Pes Planus


Flat Foot

Also sometimes called "fallen arches", the condition of flat feet is characterized by a lack of appropriate arch in the inner foot. It can be a genetic condition or the result of improper body mechanics. Often the whole of the foot will contact the ground with little to no arch being present. Because a normal foot is structurally able to support the weight of the body thanks to the bone structure that comprises the arch, a flat foot often is unable to properly support this weight and will cause extreme pressure in the joints in the foot and above, such as the ankles, knees and hips. Other problems such as tendonitis, bunion and hammertoe deformities, arthritis of the foot joints, and chronic fatigue of the leg muscles can also result.


Flat feet in adults can appear for a number of reasons. Arches never developed properly. Damage to the tendons that support the arch. Damage or inflammation of the posterior tibial tendon which runs from your lower leg, down and across your ankle, and connects to the middle of the arch. Trauma involving broken bones in the foot. Rheumatoid arthritis. Aging, pregnancy, nerve damage, obesity or even diabetes.


Feet tire easily and become painful and achy, especially around the arch, ankle and heel. Swelling on the inside bottom of your feet. Back and leg pain. Difficulty standing on toes.


An examination of the foot is enough for the health care provider to diagnose flat foot. However, the cause must be determined. If an arch develops when the patient stands on his or her toes, the flat foot is called flexible and no treatment or further work-up is necessary. If there is pain associated with the foot or if the arch does not develop with toe-standing, x-rays are necessary. If a tarsal coalition is suspected, a CT scan is often ordered. If a posterior tibial tendon injury is suspected, your health care provider may recommend an MRI.

What is PES Planovalgus deformity?

Non Surgical Treatment

Have you found yourself in the store looking at all the different foot care products? There is everything from massaging gel insoles to foam arch supports and heel cushions. If your arches fall the same amount on each side, you might be able to use an insert off the shelf. If they fall differently, then a generic insert will not fix the imbalance. If you have a high arch, a generic insert will likely not be high enough for full correction. Good custom orthotics provide a number of advantages over the generic inserts that you find in the store. Custom orthotics can take into account your body weight and degree of flexibility in your foot, not someone else?s. They also account for the anatomical differences in your feet. The corrected height of one arch is often higher in one foot than the other. A G-Laser foot analysis can provide you with this information.

Surgical Treatment

Flat Foot

A combination of surgical procedures can be used to reconstruct the flatfoot. Generally, these procedures can be separated into those that correct deformities of the bones and those that repair ligaments and tendons. Your orthopaedic surgeon will choose the proper combination of procedures for your foot. Surgery of the foot can be performed under regional anesthesia, which is numbing the foot and ankle with a nerve or spinal block, or general anesthesia, which may require a breathing tube. A nerve block is often placed behind the knee to reduce pain after surgery.


Flatfeet in children are often an inherited family trait, but it may be possible to prevent the condition in some cases. Recent research has shown that there are several social or cultural factors that can cause flatfeet. These factors include the following, obesity, overweight, unnecessary orthopedic treatments, wearing rigid shoes at a young age, In 1992, a study in India of 2300 children aged 4-13 demonstrated a significant difference in the rate of flatfeet among those who wore shoes regularly and those who did not. In this study, wearing inflexible, closed-toe shoes in early childhood was shown to have a negative effect on the normal development of arches. Children who were allowed to go barefoot or who wore light sandals and slippers had a much lower rate of flatfeet. In 1999, a study in Spain of 1181 children aged 4-13 revealed that the use of orthopedic shoes for treatment of flatfeet in children not only failed to correct the problem, but actually worsened the condition by preventing the normal flexing and arch development of bare or lightly protected feet. Finally, in 2006, a study of 835 children aged 3-6 showed significant differences in the rate of flatfeet based on weight, with normal-weight children having lower rates of flatfeet than children who were overweight or obese. Among adults, flatfeet due to injury, disease, or normal aging are not preventable. However, when flatfeet are related to lifestyle factors, such as physical activities, shoe selection, and weight gain, careful attention to these factors may prevent the development of flatfeet.

After Care

Time off work depends on the type of work as well as the surgical procedures performed. . A patient will be required to be non-weight bearing in a cast or splint and use crutches for four to twelve weeks. Usually a patient can return to work in one to two weeks if they are able to work while seated. If a person's job requires standing and walking, return to work may take several weeks. Complete recovery may take six months to a full year. Complications can occur as with all surgeries, but are minimized by strictly following your surgeon's post-operative instructions. The main complications include infection, bone that is slow to heal or does not heal, progression or reoccurrence of deformity, a stiff foot, and the need for further surgery. Many of the above complications can be avoided by only putting weight on the operative foot when allowed by your surgeon.