Treatment for fallen arches concentrates on giving the feet the support that they would otherwise have had with a normal foot arch, with arch supports and orthotic insoles a great choice. Both of these orthotic devices help to improve foot function, and support the arch and lift it up, easing the strain on the muscles, bones and ligaments in the feet and lower body. They help with proper weight distribution and can prevent muscle fatigue and the resultant injuries which often occur. Whilst many musculoskeletal conditions can be corrected by surgery, with flat feet and fallen arches it is rarely effective, and conservative treatments remain the best bet.
Pes Planus, or flat feet, are commonly encountered with Down syndrome. In fact, this foot type will be seen in the vast majority of individuals. This condition may present with neutral gait (no excessive flattening of the arch) in mild cases or may be aggravated by the hypotonia and allow severe pronation (flattening of the feet). In both cases, an orthotic or custom insert for the shoes can support the flattening of the foot against gravity and produce a more ideal walking (gait) pattern. This will reduce fatigue and allow the individual to remain active and more involved.
Unless there are deformities in the bones that do not support the structure on the arch – the only thing that will create it or remove an arch is the tissue that surrounds it. Bones can’t keep themselves in place without a collective effort (cranial bones may be the exception because of their intricate system of interlocking sutures). Next, we have 2 very important muscles whose tendons both attach to the base of the first metatarsal. One comes from the outside and the other from the inside (front) of the leg and together they form a stirrup that supports the medial arch of the foot.
Sarcoidosis is a disease that causes the formation and growth of tiny masses of inflammatory cells; the lungs are one of the organs most commonly affected. Abnormal immune system activity seems to trigger sarcoidosis, and its effects vary from person to person. Usually it resolves itself on its own, but some patients experience symptoms for years or even a lifetime. Taenia solium is the tapeworm infection that is caused by eating pork contaminated with taenia solium. Taenia solium, or pork tapeworm, transmission can also occur when an infected individual fails to wash their hands after using the toilet (hand to mouth contamination). Pork tapeworm can be treated with prescription medication.
Arthroereisis implants. Arthroereisis type procedures are popular in younger patients. (Figure 2) The procedure calls for placing an implant (metallic or absorbable) into the rearfoot between the talus and calcaneus. 20-23 This implant acts as a spacer that prevents and/or limits excessive pronation or collapse of the arch. Although implanting an arthroereisis device is indeed a surgical procedure, it is probably the least invasive flatfoot procedure because it does not involve the cutting of bone or tendon work. There is also a perception that the procedure is somewhat reversible, if the implant needs to be removed at a later date.
Orthotics realigns the foot and ankle-bones to their natural position thereby correcting the problem of over-pronation. This restores our normal foot function that alleviates not only foot problems but also ailments in other parts of the body. Of late the shoes use soft material for reasons of initial comfort and are not really supportive or stable for a healthy gait. The use of sandals or ‘flip-flops’ during summer is of no help to patients with over-pronation as they are not satisfactory in biomechanical terms. Lateral plantar nerve combines with part of medial plantar nerve. The 2 nerves combine, creating a nerve with larger diameter than nerves going to other digits.
A significant number of people with fallen arches (flat feet) experience no pain and have no problems. Some, however, may experience pain in their feet, especially when the connecting ligaments and muscles are strained. The leg joints may also be affected, resulting in pain. If the ankles turn inwards because of flat feet the most likely affected areas will be the feet, ankles and knees. Some people have flat feet because of a developmental fault during childhood, while others may find that the problem develops as they age, or after a pregnancy. There are some simple devices which may prevent the complications of flat feet.
Flexible flatfeet are considered normal in young children because babies are not born with a normal arch. The arch may not form fully until sometime between ages 7 and 10. Even in adulthood, 15% to 25% of people have flexible flatfeet. Most of these people never develop symptoms. In many adults who have had flexible flatfeet since childhood, the missing arch is an inherited condition related to a general looseness of ligaments. These people usually have extremely flexible, very mobile joints throughout the body, not only in the feet. Flatfeet also can develop during adulthood. Causes include joint disease, such as rheumatoid arthritis, and disorders of nerve function (neuropathy).
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