Flat Footed: 5 Problems Faced By People With Fallen Arches

Many of us take the arches in our feet for granted, but your arches aren’t without purpose. The arches in your foot exist because the tendons in your foot and lower leg pull together to make space at the bottom of your foot. If those tendons fail, the arch disappears. When that happens, it throws off the biomechanics of your foot and leg and can result in a long list of stress injuries that can leave you limping – or even stuck in bed. Fallen arches, also known as hyper pronation or overpronation, threaten the integrity of your foot.

What Are Fallen Arches?

Fallen arches, or flat feet, occur when your tendons don’t work together to keep the arches of your feet raised. For some people, it begins as an abnormality at birth, but it can also result from an injury, such as stretched, torn, or damaged tendons.

Other causes include:

• Broken bones
• Posterior tibial tendon damage
• Rheumatoid arthritis
• Nerve issues

You also may have a higher risk of fallen arches if you are obese, have diabetes, or are pregnant. Flat feet also become more common as we age.

The arches of your feet aren’t a design fluke. The biomechanics of the lower leg and foot is exceptionally complicated (think rocket science), and even a small disruption to the function of your leg and foot can cause crippling pain and injury.

What Are the Types of Flat Feet?

There are three types of flat feet:

• A flexible flat foot is the most common type of flat foot, which presents itself with arches appearing only once you lift your feet from the ground. However, this type of flat foot typically begins in childhood and doesn’t lead to any pain.
• The tight Achilles tendon. The Achilles tendon connects the heel bone to the calf muscle. Once this tendon is too tight, you might feel pain when running or walking. This condition leads to a premature heel lift once you are walking or running.
• Posterior tibial tendon dysfunction is a type of flat foot that occurs in adulthood once the tendon that connects the calf muscle to the inside of the ankle is injured, swollen, or torn. Once the arch doesn’t receive the support it needs, you will experience pain on the inside of the foot, the inside of the ankle, and the outside of the ankle. Depending on what causes the condition, you might have flat feet on either one or both feet.

It is recommended that patients with any flat feet seek the care of a podiatrist who is experienced in treating this condition.

What Are the Symptoms of Flat Feet?

Flat feet can cause a range of symptoms, from mild to severe. The severity of arch/foot flattening does not always correlate with the intensity of symptoms.

• Arch pain and heel pain
• Muscle cramps within the foot
• Lower back pain
• Leg fatigue

Patients typically experience pain while walking or running. The pain might be acute and localized to a broad, spreading ache. Pain is not a common complaint among children, but fatigue is. If your child struggles to keep up with their peers on the playground or gets tired easily when walking a long distance, this could be a sign that they have flat feet.

How Are Flat Feet Diagnosed?

The specialist will evaluate the structure of your feet and how they move and change shape while you are sitting, standing, or walking. An X-ray can be used to determine the severity of your condition. An MRI may be requested if a tendon or ligament injury is suspected. In rare cases where it is suspected that your flatfoot is not flexible, a CT scan may help rule out the joining of two bones that could contribute to a decrease in motion.

What Happens When You Have Fallen Arches

Your fallen arches don’t just leave you with full footprints in the sand. They can also cause other injuries to your feet and legs due to undue or new pressure on your ankle, tibia, or patella.

Here are a few common injuries or strains caused by fallen feet.

Knee Pain (Patellofemoral Pain Syndrome)

When your arches fall, it causes rotational changes to the way your ankle moves. Those changes make their way up to your knee, resulting in patellofemoral pain syndrome or knee pain.

You’ll recognize the pain because the area behind your kneecap (where it meets your thigh bone) suffers. In most cases, the pain is gradual. It starts as a nagging feeling but makes its way up to a point where sitting, standing, walking, and running are painful.

To get rid of the pain, you need physiotherapy and a fix for your fallen arches (assuming they are the root cause).

Plantar Fasciitis

Plantar fasciitis is a common strain injury that causes crippling pain in your heel and occasionally in your arch. It’s particularly common among runners and hikers, and people who stand eight hours a day.

What hurts when you have plantar fasciitis? The cause is inflammation of the plantar fascia. Your plantar fascia connects the heel to the toes and runs along the bottom of your foot.

The strain caused by flat feet on the rest of your foot can cause plantar fasciitis.

We often treat plantar fasciitis with physical therapy, night splints, or custom orthotics (arch supports). These interventions distribute the pressure on your foot correctly to relieve the cause of inflammation.

Achilles Tendinitis

When you have flat feet, you have an increased range of motion in your midfoot – and it’s abnormal. To keep up, your Achilles tendon needs to work harder, which can lead to strain and Achilles tendinitis.

Symptoms of tendonitis include tight calf muscles, difficulty achieving a full range of motion when you flex your foot or swelling in your heel.

To fix flat feet-induced Achilles tendonitis, we need to treat both the overpronation and use the RICE method. You may also need to reduce your physical activity and use stretching techniques for your lower legs.

Shin Splints (Medial Tibial Stress Syndrome)

The excessive pronation cause by flat feet puts both additional and altered stress on your lower leg. It impacts the inside of your tibia (your shin), leading to shin splints.

Shin splints cause a dull ache in the front of the lower leg, around your bone (or in the muscles).

Not everyone who deals with flat feet also experiences shin splints. It often occurs in conjunction with overpronation along with overtraining.

However, you will need to adjust your activity levels according to the pain you experience. If your shin splints worsen during physical activity or you deal with pain, you need to stop all activity.

Treating shin splints caused by flat feet requires treatment for the fallen tendons as well as ice and elevation (and potentially anti-inflammatories) for the shin splints.

Tibialis Posterior Tendinopathy

A tendon connects the inside of your lower leg to the back of your ankle bone and joins your midfoot. Thanks to the stress of flat feet, the tendon (tibialis posterior) can experience

• tendonitis (inflammation)
• tendinosis (degenerative tendon)
• tenosynovitis (inflamed tendon sheath)
• ruptured tendon

Other causes include over-training, a change in training surface, wearing high heels (toe walking), and hill running.

If you have tibialis posterior tendinopathy, you will have pain walking, running, or jumping. This form of tendinopathy’s most recognizable characteristic is the limp that accompanies it.

To deal with the inflammation, you’ll need to reduce your activity and use the RICE (rest, ice, compression, elevation) method. When flat feet are the cause, you need to fix them to relieve the pressure on your tibialis posterior.

Fallen Arches Can Cause Many Painful Injuries

Your arches are more than a random design. The gently curving arch supports your foot, ankle, lower leg, and knee biomechanics. Everything in your leg changes when you have fallen arches or on flat feet.

The pressure from these changes can cause injuries to the tendons and other tissues in your feet, lower leg, and knee. You won’t find relief from those injuries unless you fix your fallen arches.

How Are Flat Feet Managed or Treated?

Flat feet can be treated in a variety of ways, including:

• Supporting the feet with orthotics which are inserts you can put inside the shoes for additional support.
• Incorporating a few lifestyle changes such as starting a specific exercise program or a diet, as well as avoiding standing or walking for long periods.
• Taking nonsteroidal anti-inflammatory medications to manage the pain and inflammation of the feet.
• Having surgery to repair or lengthen the tendons, fuse the bones or joints, or create an arch in the feet.
• Most of those with flat feet may benefit from wearing shoe supports or special shoes. Surgery is the very last resort. If all other treatments have failed and the surgical outcomes are viewed to be positive, it can be considered.

An experienced podiatrist at a podiatry center in NJ can help your feet work the way they should. Visit us in Clifton, NJ, or Wayne, NJ, to learn how we can help protect your feet (and ankles, legs, and knees) so that you can walk through life pain-free.