Flatfootedness, also known as “pes planus”, is a lowering of the longitudinal (medial and lateral) and/or the transverse arches of the heel. The heel arches have an important role, because they provide optimum conditions for work of muscles and, thus they tire less. They act as an elastic shock-absorbing system of the body. The most common to suffer is the medial longitudinal arch, but there can be only pes planus transverses (lowered transverse arch), or the lowering can be complete. The healthy foot of the person has three support points – the heel bone, and the metatarsophalangeal joints of the I^st and V^th toe. Any understating of the problem can have serious consequences for the future. If there is a case of pes planus, the normal biomechanics of walking is disturbed, which at a later stage leads to joint pains in the lower limbs – the ankle, knee and hip, as well as in the lower back, unpleasant blisters on the heels can also appear. It is possible to develop arthrose disease, the occurrence of varices of the lower limbs, etc. It is important to discover and diagnose the problem in time, in order to prevent complications, both in children, and in adults.

Flatfootedness can be inborn or acquired (in over 90% of the cases).

Etiology: The factors, affecting the acquisition of a flat foot are various. In our strive to keep up with fashion, we wear tight and uncomfortable shoes. Wearing shoes with very high heels creates conditions for deformations of heels, and this affects mostly women. It is possible in some cases to retain loose flat feet until you come of age, and even after that, usually due to the natural flat shape of the foot. Adults with loose flat feet often have loose connections in other joints in the body as well. It is not uncommon for the pathological condition to develop later in life, as a result of tearing of a muscle tendon, or a trauma in the foot. The lack activity and leading a sedentary life style is another quite common cause. The harmful habit of us going everywhere in our cars, instead of just walking, and the sedentary way of life are also exacerbating factors. Even in summertime, we wear flip-flops and sandals instead of walking barefoot, whenever this is possible. Spending long hours in front of the computer all day long, staying in one place for a long period of time are negative factors for the skeletal and joint system of the human body. The professional burden is a prerequireiste for the lowering of the arch for some professions, like: surgeons, dentists, hair-stylists, sales staff, etc. Obesity also leads to the overloading of the ankle-foot complex. It is also possible to have pes planus during pregnancy. That is why, it is advisable for pregnant women to wear orthopedic shoes. It is crucial for post-traumatic conditions and fractures of the lower limbs, as well as after prolonged immobilisation, to perform aimed and regular exercises against flat feet, because this is the way to rescue the arch. Immediately after the fracture, the foot muscles are weak and have to be stimulated in order to avoid overloading the ligaments and dislocating the foot bones. The hereditary weakness of ligaments and foot muscles, as well as some inborn bone anomalies, like rickets and paralysis of the muscles of the lower limbs, can also be etiological causes of its development. With the advance of age, the likelihood of developing flat feet increases. Around 25% of the people over 50 suffer from this problem.

Clinical data: The typical symptoms are getting tired quickly when walking, accompanied with pains in ankles, shins, knees and hips. The gait is ungainly. When we suspect pes planus, it is relevant to perform a computer plantogram. More severe cases can be discovered with a simple inspection. It is possible to increase the shoe size, which is used by the patient. Flatfootedness in adults leads to excessive pronation – excessive turning of the heel inside during walking or running. A process, which increases the load of heels and calves, which in time can lead to a number of other issues of the motor system. A very characteristic symptom of the excessive pronation is the wear mostly of the internal edges of the soles.
It is especially important, since we are either future or current parents, to observe little children for such signs. This is called preventive care to avoid flat feet. If they complain that their feet hurt them, and they want to be cuddled, and that they got tired of walking a short distance, it is mandatory to consult an expert in physical and rehabilitation medicine. In early childhood, it is possible to correct flat feet and prevent its evolution with the growing of the child. Until the age of 4-5 years, children have the s.c. “physiological flatfootedness”. This is the period when the arch is formed. For the normal forming of the heels in children, it is very important to wear comfortable socks, shoed must be comfortable and must not have been worn by another child. You must not save on money for the shoes of your children. When buying shoes, they must definitely be tried by the child and must not be too tight. The heel must be in a comfortable anatomic shoe in order to move freely.

When the child starts walking, it needs to have very soft shoes. it is advisable for children to walk barefoot any time they have a chance.

Sometimes, flatfootedness occurs without the characteristic fatigue and typical symptoms. An examination by an expert allows for its timely discovery and correction in children, as well as for the symptomatic treatment in adults – relief of the symptoms and not allowing the development of the specific complications. In the early phase of the development of flat feet in children, the insoles must not be the leading therapy. The focus must be on exercises. As soon as we discover this problem, we must not fall into meaningless panic and anxiety, and look for an expert to consult us.

Treatment: A set of exercises is used to counter flat feet, combined with orthopedic insoles. The insoles can be purchased after making a computer plantogram, or taking an imprint of the feel and consider the individual features of the patient. An X-ray image of the foot can be taken. Sometimes, flatfootedness is accompanied with hallux valgus or another pathology of the foot and the ankle. Good effect has the massage of the foot.

The main purpose of the kinesitherapeutic complex is to reinforce the foot muscles through various exercises, in order to eliminate the harassing pains in the legs and work for the correct and elegant gait.

The orthopedic shoes by Dr.Orthopedic have a custom-made orthopedic insole, which ensures the proper solution for patients with flat feet.