| Fallen Arches
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Fallen Arches

Fallen arches is another term used to describe flat feet. A person with fallen arches often has problems with foot alignment. The shoes may pronate side-to-side or will lean in towards each other.


What contributes to fallen arches?


Factors that contribute to fallen arches include:


  • Weak arches
  • Age
  • Tendon injury
  • Arthritis
  • Pregnancy
  • Diabetes

Progressive fallen arches can become painful due to tendon inflammation. The tendon inside the foot becomes stretch, inflamed, and torn, which if untreated, can lead to severe disability.


Will I need surgery to treat fallen arches?


Many people with fallen arches do not have pain or problems walking. However, fallen arches can lead to serious leg, ankle, and/or foot pain. The feet need evaluated when this occurs. The corrective surgery is only considered after the patient fails on many non-surgical options.


What causes fallen arches?


People are often born with flat feet, meaning it is hereditary. However, the foot arch may collapse due to obesity, weakness of the tendon and bone structure, or many other problems.


Are there different types of flat feet?


A normal foot has an arch, that is non-weight-bearing. There are two basic kinds of flat feet:

  • Rigid flat feet (RFF) – Rigid flat feet are caused by an underlying pathology. A common cause is a condition called tarsal coalition. This is where 2 or more of the 7 tarsal foot bones fuse together.
  • Flexible flat feet (FFF) – Flexible flat feet are caused by ligament laxity, where ligaments connect the bones together become weakened. The muscle that forms the arch is also weakened, which results in loss of arch height.


How do flat feet develop?


For toddlers, flat feet are normal. However, as the child gets older, the foot tendons strengthen and tighten to form the medial longitudinal arch. By age 3-6 years, this arch is developed. However, some children never develop this arch, which is FFF.


Does fallen arches and flat feet increase the risk of injury?


In a study involving 250 U.S. Army recruits, researchers found that trainees with flat or fallen arches had a lower risk of injury than those with high arches. In another study published in a pediatric journal, of children studied aged 11 to 15 years, no disadvantages were noted in sports performance among people with flat feet. Children with flat feet could function normally and accomplished all 17 of the motor skills tested.


How are fallen arches diagnosed and treated?


Fallen arches are diagnosed using x-rays and physical examination. The goal of treatment involves reducing pain and stabilizing the foot, to prevent injury and further problems with the foot’s integrity. Conservative treatment measures include:

  • Applying cold packs to the painful region 3-4 times each day.
  • Stopping/decreasing activities that aggravate foot pain.
  • Taking NSAIDs, such as naproxen or ibuprofen.
  • Losing weight and participating in low-impact sporting activities.
  • Wearing orthotics, a short leg cast, or a walking boot to stabilize the arch and tendon structure.


When is surgery an option?


Surgery is only considered after the pain does not improve. The orthopedic specialist will attempt 6 months of conservative treatment before scheduling surgery. Surgical options include replacing the damaged tendon with another foot tendon, fusing joints to stabilize the back portion of the foot, or realigning bones to create a normal arch.

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