The terms “fallen or collapsed arches” and “flat feet” are often used interchangeably. However, there are some differences between the two conditions.
A collapsed arch is a flat foot that develops in adulthood due to weakened ligaments supporting the arch, often referred to as posterior tibial tendon dysfunction. In contrast, flat feet usually begin in childhood and occur when the foot arch doesn’t form properly.
What are Flat Feet?
Fallen arches or flat feet, is a condition where one or both feet have little to no arch. When standing, the arches of your feet may not be raised, resulting in the pads of your feet pressing into the ground. In most cases, the arch in the foot is not noticeable, but it may appear when you lift your foot.
At birth, all babies have flat feet, and arches usually develop by age 6. About 2 in 10 children still have flat feet as adults. Flat feet can also develop later in life for some people.
This condition does not pose a problem for most people. But if it causes foot pain or other issues, non-surgical treatments such as wearing orthotics or shoe inserts are available to provide relief.
What are the Types of Flat Feet?
Whether flat feet persist from childhood or develop in adulthood, they can cause problems. The types of flat feet include:
Flexible Flat Feet
Flexible flat feet is a common type of this condition in which the tendons and ligaments in the arches of the feet can stretch, tear and become inflamed. The arches may be visible when you’re not standing. However, if you stand or apply weight to the feet, the arches may disappear.
This condition typically develops during childhood or teenage years. It may affect both feet and often worsens gradually with age.
Rigid Flat Feet
A person with rigid flat feet has no noticeable arches either when standing or when sitting. Standing tends to apply weight on the feet compared to sitting. Typically this condition will develop during teenage years and worsens with age.
Rigid flat feet can cause foot pain and make it challenging to flex the feet up or down, or move them side-to-side. It may affect one or both feet.
Fallen Arch or Adult-acquired Flat Foot
Adult-acquired flat feet occur when the arches unexpectedly drop or collapse. This condition can cause the foot to turn outward, which may result in arch pain. The most common cause is inflammation or a tear in the tendon that supports the arch of the foot; it may not affect both feet.
Vertical talus is a birth defect (congenital disability) that can occur in some babies that prevents the formation of foot arches. Here, the talus bone in the ankle is in the wrong position, causing the bottom of the foot to resemble that of a rocking chair. Vertical talus is sometimes referred to as a “rocker-bottom foot.”
What Causes Flat Feet or Collapsed Arches?
Collapsed arches are most likely the result of instability and inadequate support for the arch of the foot.
The posterior tibial tendon runs along the inner side of the ankle. It helps position your foot correctly, allowing the Achilles tendon to power your forward movement while walking or running. The posterior tibial tendon needs to exert a slight upward pull on the arch of the foot, placing it in a more stable and rigid position.
In some individuals, the tendon can become worn out over time or get injured for reasons that are not always clear. This degeneration of the tendon can make it difficult to heal. Torn tendons can result in arch collapse over time if left untreated.
How are flat feet diagnosed?
To diagnose this foot problem, your doctor may assess symptoms and evaluate how the arches of the feet look when you are sitting, standing and walking.
The doctor will examine your feet to determine two things:
- Whether you have flat feet and
An examination may include:
- Checking your health history for evidence of injuries or illnesses that could be linked to fallen arches or flat feet.
- Evaluating the strength of the muscles and tendons in your feet and legs, including the Achilles tendon and posterior tibial tendon.
- Observing your feet and legs while you stand and execute simple motions such as rising on your toes.
- Examining the soles of your shoes to identify any distinctive wear patterns.
- Taking X-rays or an MRI to evaluate the bones, joints and soft tissues of your feet and ankles.
How are Flat Feet Managed or Treated?
Flat feet may not always lead to significant issues and may not require treatment. However, if you experience foot pain, stiffness or other problems, your podiatrist may recommend non-surgical treatments.
Some of the non-surgical treatments for flat feet include:
- Taking a rest, applying ice and taking Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) to reduce inflammation and alleviate pain.
- Stretching and strengthening tight tendons and muscles to improve flexibility and mobility.
- Wearing supportive devices such as custom-made orthotics or shoes, foot or leg braces, etc.
If the pain or foot damage is severe, you may be required to undergo surgery. Some of the procedures may include:
- Combining or fusing together foot or ankle bones (arthrodesis).
- Removing spurs or bony growths (excision).
- Reshaping the bone (osteotomy).
- Cleaning the tendon’s protective covering (synovectomy).
- Taking tendons from other parts of your body and adding them to the ones in your foot (tendon transfer).
- Raising the foot arch more naturally through bone grafting (lateral column lengthening).
What is the Difference Between Fallen Arches and Plantar Fasciitis?
A flat foot is a structural issue where the arches collapse or flatten out. This foot problem may come with no associated symptoms. But without treatment, flat feet can lead to complications that may include plantar fasciitis.
Contrastingly, plantar fasciitis is a condition where the plantar fascia becomes inflamed, leading to heel pain. The plantar fascia is a connective tissue band that attaches the heel bone to the base of the toes. It supports the foot arch and helps to absorb shock when walking.
Typically, the foot’s arch protects the plantar fascia so it can handle the demands of everyday use. But when the plantar fascia is subjected to excessive stress caused by factors such as flat feet, wearing ill-fitting footwear or abnormal walking patterns, small tears can develop in the tissue.
What are 2 symptoms of plantar fasciitis?
You may experience sharp or stabbing pain when using your affected foot or after applying pressure on your heel. You will likely experience increased pain in the morning or when standing up after sitting or sleeping.
Can You Prevent Flat Feet?
Image source:FA RenLis/Wikimedia Commons
Unlike fallen arches, you can not prevent flat feet, especially in people born with such a condition. However, to avoid developing flat feet later in life, it is advisable to maintain a healthy weight. Also, women should avoid wearing high heels for prolonged periods.
Let Us Help You Rebuild Your Collapsed Arch
Consult your local foot and ankle surgeons if you have flat feet. This condition can lead to a range of symptoms, from mild discomfort to chronic pain. If the foot pain you’re experiencing is due to fallen arches or flat feet, please don’t hesitate to get in touch with one of our podiatrists at Adelaide Foot and Ankle today.
How do you know if your arch has collapsed?
People with collapsed arches may experience painful or achy feet, particularly in the areas of the arches and heels. Sometimes, the condition may only affect one foot.
How serious is a collapsed arch?
A foot arch that unexpectedly collapses can cause the foot to turn outward and cause pain. The most common cause is the dysfunction of the posterior tibial tendon, which is a tear or inflammation of the tendon in the leg that supports the arch.
Can a collapsed foot arch be fixed?
Performing exercises regularly, like heel stretches, can help alleviate pain and potentially correct fallen arches. When a patient experiences arch pain, a typical approach may involve a combination of conservative treatments such as orthotics, physical therapy or bracing.
Where does it hurt when you have fallen arches?
When your heel bone shifts outward it may cause pain on the outside of your ankle.
What does a fallen arch look like?
If your entire foot touches the ground, then you may have a flat foot or fallen arch. On the other hand, your arches are normal if the middle part of your foot is slightly raised off the ground.