Adult Acquired Flat Foot

Adult acquired flat foot is a condition that has a number of stages and can be asymptomatic initially but may progress to a painful, chronic condition if untreated.

Signs and Symptoms of Adult Acquired Flat Foot

A change in the height of the arch on the inside of your foot (the medial longitudinal arch) is often one of the initial signs.
This change in height can be subtle and may go unnoticed for a period of time.
In some instances, the change in arch height may be accompanied by pain.

Pain: Pain may be present either in the arch or along the course of muscles and/or tendons that help support the arch.
These tendons and muscles run along the inside of the foot, behind the ankle and up into the calf area.
Accordingly, pain may occur in any of these areas.
Pain may also occur in other parts of the foot.
However, this largely depends on damage to other supporting structures within the foot.

In some cases, pain is preceded by an event that places extra stress loads on various supportive structures within the foot.
For example, this can happen when stepping on a curb awkwardly.
However, in some cases there may be no identifiable cause of the pain and the pain may develop without any obvious change in the height of the arch.
This tends to be the case for people who already have flat feet that excessively pronate (where their feet roll inwards excessively and the arches of their feet have already collapsed).

Factors that may contribute to the development of Adult Acquired Flat Foot

Biomechanics

Excessive pronation (where the feet roll inwards and the arches of the feet collapse) elongates the feet.
This elongation tends to increase the work required of muscles, particularly those within the lower leg.
The increase in work, over a period of time, can cause the muscles to fatigue. This may lead to a further collapse in the medial longitudinal arch.

Some people require footwear that provides additional support to their feet. This is particularly the case for people whose feet excessively pronate.

Unsupportive footwear

Occupation

When excessive pronation is a factor, standing or walking for long periods of time places additional work load demands on the muscles in the lower leg. This further increases the potential for injury to the foot and lower leg.

Increasing activity too quickly

Stages of Adult Acquired Flat Foot

Stage 1 The medial longitudinal arch may have reduced in height with pain and/or swelling below or behind the ankle.

Stage 2 The medial longitudinal arch has collapsed; additionally, pain and swelling around the arch of the foot or below and behind the ankle may be present. The foot can still generally be corrected back to a more neutral position.

Stage 3 The medial longitudinal arch has collapsed and pain and swelling around the arch of the foot or below and behind the ankle may be present. At this stage, the foot can generally no longer be corrected back to a more neutral position. Osteoarthritis is frequently also present in the joints of the rearfoot.

Stage 4 In addition to the above, osteoarthritic changes will likely also be visible within the ankle joint.

Treatment options for Adult Acquired Flat Foot

Stage 1 and 2 Treatments

Conservative treatments tend to be more effective if the problem is identified early and has not progressed passed stage 2.

Some conservative measures include:

Relative Rest

Reducing activities that aggravate the condition.

Stretching Exercises

Stretching of tight muscles, particularly of calf muscles, may help. Tight calf muscles can lead to an increase in the amount of excessive foot pronation and, as a result, Adult Acquired Flat Foot may develop.

Remedial Massage

Massage by a qualified professional can help reduce muscle tightness.

Acupuncture

Research has shown that acupuncture may reduce pain. Acupuncture may therefore provide pain relief for some people who have Adult Acquired Flat Foot.

Footwear

Footwear that is worn-out has a reduced ability to provide effective support. New footwear may therefore assist, including advice from a podiatrist regarding the most appropriate footwear for your condition.

Orthotic Shoes & Thongs

Orthotic insoles and orthotic shoes & thongs can provide a very cost-effective, long-term solution to controlling excessive foot pronation, therefore reducing the pain associated with Adult Acquired Flat Foot.

Stage 3 and 4 Treatments

Conservative treatment (as outlined above) may provide some relief. However, due to the extent of the problem, a surgical opinion is often sought.