Do you have pain in your feet without any injuries? Is your foot turning in while standing and walking? Unknowingly, you might have a condition called flat feet. ‘Flat feet’ is a condition in which the arch of the foot is abnormally flattened down, bringing the entire sole in contact with the ground. As with many other foot and ankle conditions, flat feet (also known as fallen arches) isn’t something that we really think about until it starts affecting our day-to-day lives. In some cases, flat feet, considered to be a somewhat normal variation in the foot structure, does not always mean it will turn into a problem. However, if the condition is something you are living with, then it’s important that you understand and stay on the lookout for any indicators that could cause its worsening. There are two different types of flat feet – rigid and flexible. If you have rigid flat feet, then your arches are altogether absent, whether you are in a sitting or standing position. This is usually a result of abnormal formation of the joint or bones but can result from neglected flexible flat feet. Often, rigid flat feet are painful and require treatment. On the other hand, if your feet do have visible arches when they are not bearing weight, like when you are sitting or lying down, then you most likely have flexible flat feet. This is typically caused by wear and tear of the bones or tendons that connect your heel to your toes. In these cases, simple orthotics (insoles) and change in one’s shoes may do the trick. And like most foot and ankle conditions, there are many other factors that contribute to the development of flat feet – some may occur early on in life, while others may start showing signs later in adulthood. Family genetics is a rather uncontrollable cause of flat feet. Some people have flat feet since childhood; we all start out with flat feet until our arches fully develop, though sometimes this development never takes place. While others will stumble upon this condition well into adulthood due to repeated impact from walking and running, wearing shoes that lack appropriate arch support, and improper treatment or healing of injuries. Other possible causes of flat feet include muscular dystrophy, ruptured tendon, tarsal coalition, pregnancy, diabetes, arthritis and obesity. You should also keep in mind that, as you age, your posterior foot muscle (posterior tibial tendon) will also weaken over time, and when the tendon is damaged, this will result in a flat foot sooner or later. There is a simple at-home testing method you can try! First, wet the bottoms of your feet, and then stand normally on a flat piece of cardboard or paper that will allow you to see your footprints. Finally, step off the surface and take a look at your footprints. If your arch is normal, you should see an imprint with a curve on the inside of your foot. If you have flat feet, the wet marks will show along the entire bottom of your feet. But there are also other good indicators you should keep in mind:

• Pain or discomfort in your feet (especially in the arch area), the inside of your ankles, or your calf
• Foot pain or discomfort after walking or standing for long periods of time
• Feet that turn outward when you’re standing at rest
• Pain in feet or legs associated with sports or running
• A strained feeling in your hips or lower back
• Shoes that wear unevenly on the bottom (specifically, the wear pattern will be heavy on the inside edges)

If your flat feet test has come up “positive” and you are experiencing one or more of the symptoms above, there is no need to panic – there are plenty of treatments that can help you get back on your feet as quickly and as safely as possible. Many people with flat feet find that it affects many aspects of their overall health. Because fallen arches, or flat feet, fail to give your feet the support they need, you’re more likely to experience foot pain. A condition called plantar fasciitis is more common in people with flat feet as well. Plantar fasciitis occurs when the tendons in the feet are overstretched. This condition causes severe pain in the feet, especially in the morning. Flat feet tend to cause another condition called overpronation, which is when the ankles roll inward while you’re walking. This can lead to foot and ankle pain. Because your feet are the basis of support for your entire body, having flat feet and overpronation can cause problems with your spinal alignment. You may notice that you also have problems with your hips, knees and lower back. How do our bodies efficiently distribute our weight? The answer is in the arches of our feet. When those arches are lowered or nonexistent, it changes the way our legs carry the weight. This puts extra stress on bones, ligaments and muscles. But it’s not a serious issue for most. A significant portion of people with flat feet don’t experience any symptoms beyond getting fatigued more quickly from standing or walking. Specialists will perform a thorough evaluation of your feet and ankles in order to correctly diagnose your condition. Depending on what they find, they may recommend changes in shoes, orthotics (insoles), physical therapy or even surgery for severe cases. An easy heel cord stretch (calf stretch) may be included in your treatment plan – Stand facing a wall with your unaffected leg forward with a slight bend at the knee. Keep both heels flat on the floor and press your hips forward toward the wall. Hold this stretch for 30 seconds and then relax for 30 seconds. Resting your feet is also something that physiotherapists may recommend. Though this type of treatment is as basic as they come, resting your feet will help alleviate painful flat feet symptoms. Icing the area is another example of a ‘basic-yet-effective’ step you can easily take whenever your arches start giving you grief. Follow these five tips for happy, healthy flat feet. Avoid wrong footwear such as flats and heels. Make sure your shoes have an arch support. Try inserting insoles, if you don’t want to buy new shoes. Get shoes that are designed for what you’re doing, running shoes for runners and comfortable tennis shoes for tennis players. Flat feet can really become a burden in your daily life if they go untreated. But with professional guidance, your fallen arch trouble can become less of a burden. So, don’t ignore your painful flat feet in the hopes that the discomfort will eventually go away.  Dr Basnet heads the Physiotherapy Dept at HAMS Hospital Feature Image: File