According to the Australian Journal of General Practice, approximately 25% of Australians will have pes planus in at least one foot.[1] Australian research also noted that pes planus is a common problem in children between the ages of 5-14 and affects up to 78% of this population to some degree.[2]
Rather than being a condition, pes planus is a medical term used to describe a collapsing foot posture. People with flat feet may not experience symptoms or future issues, depending on its severity, activity levels, and how the rest of the body moves.
Read on to understand what you should know about pes planus; the risk factors, treatment options and expected recovery time.
What is pes planus (flat foot)?
Pes planus (flat foot) describes a foot deformity where the natural arches (especially the inner sole) collapse and touch the ground. As people have varying levels of pes planus, they can either have minimal or severe collapsing foot arches.
What are the symptoms of pes planus?
Symptoms of flat feet (pes planus) include pain in the arch of the foot, heel or ankle. Some of the first signs and symptoms of pes planus include a feeling of generalised fatigue in the foot.
Common symptoms of pes planus
What causes pes planus?
Pes planus is most commonly caused by a lack of development of the foot arch through adolescence and puberty with no accurate understanding of why. If acquired later in life, it is usually caused by other risk factors, such as injury, obesity or diabetes.
Common causes of pes planus
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Obesity
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Diabetes
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Tendonitis
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Foot injuries
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Arthritis.
Sports that increase the risk of pes planus
Sports that cause overuse injuries and high-impact force on the posterior tibial tendon and the bones of the foot increase the risk of pes planus over time.
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Basketball
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Tennis
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Rugby
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Long-distance running
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Hiking
How is pes planus diagnosed?
Having pes planus affects your balance and compromises your stability. In addition, you are more prone to fatigue since your body will exert more effort to supinate the foot during walking or running.
There are several options available when it comes to diagnosing your foot pain as pes planus. One of the most common and most recommended by Australian GPs is an assessment from a physiotherapist.
Physiotherapists are rehabilitation experts that deal with musculoskeletal injuries like flat feet. They can effectively diagnose pes planus and give an appropriate intervention for your condition.
A physiotherapy assessment is simple. Your physiotherapist will start the consultation with a mini-interview and ask you about your medical history. Take this opportunity to discuss all your concerns about your injury and other medical conditions.
After establishing a background of your condition, your physiotherapist will perform various physical tests to assess the integrity of the foot arches and other structures. This will help determine the exact diagnosis and help rule out other factors that may affect your condition.
Your physiotherapist will then formulate a diagnosis and a specific treatment plan for you that will guide you through your recovery.
This will also include:
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A detailed treatment program
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Your rehabilitation goals
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Your estimated recovery time.
How is pes planus treated?
Pes planus can result in over fatigue and alter the natural mechanics of your ankle and knee, which may lead to painful conditions such as plantar fasciitis, muscle spasms and arthritis.
There are several options when it comes to treating pes planus. One of the more common and the treatment option referred to by Australian GPs the most frequently is physiotherapy.
Physiotherapists encounter various injuries of the foot daily such as pes planus. They are highly qualified to give treatment interventions and address your concerns regarding your flat foot injury.
The main focus of your treatment would be to minimise your pain, increase foot flexibility, and strengthen your weak foot and leg muscles to counteract the effects of pes planus and restore stability to the foot.
Depending on the severity of your pes planus. A physio may provide you with a combination of the following types of treatments:
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Cryotherapy - In acute situations, cold modalities can help control the swelling and pain.
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Manual Therapy - Hands-on physiotherapy is used to reduce stiffness and improves mobility in the foot.
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Stretching Exercises - Flexibility exercises can reduce tension and facilitate optimal use of the muscles in the foot.
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Strengthening Exercises - Specific exercises that target the muscles and tendon of the foot to improve the stability of the arches.
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Proprioceptive Techniques - Exercises that are used to increase the awareness and position sense of the foot to help the body align and support the arches during walking or running.
A typical physiotherapy session with your local physio will last anywhere between 30-60 minutes. It is not uncommon for patients to feel the benefits in just one session.
Next step - Creating a treatment plan made for you
After your initial visit, your physiotherapist will create a detailed care plan to help you maximise your recovery.
Self-care for pes planus
If you think you have pes planus, here are the best things you can do and avoid.
Things to do:
- Ice
Apply ice or cold packs on the painful areas of your foot after running or physical activities to help manage the pain and swelling.
- Rest
Discomfort and fatigue are usually relieved by stress. Allow your body to recover first before engaging in other physical activities.
- Wear arch supports
Wearing arch supports can distribute the load on the foot and relieve some tension.
- Stretch
Frequently stretching the Achilles tendon and calf muscle reduces the tension on the foot arches.
Things to avoid:
- Avoid running on a hard surface
Avoid running on hard surfaces such as roads to prevent excessive stress on your foot.
- Avoid wearing footwear with poor support.
Avoid wearing sandals or slippers when you are doing physical activities or sports.
Do I need a specialist or surgery?
In the scenario that you have chronic or severe foot pain, your GP may suggest further investigation to rule out any serious underlying injury.
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X-Ray: Used to scan for arthritic changes on your foot
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MRI: Provides a high-quality image for both soft and hard tissues of the foot
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Ultrasound: Can be used to scan for tendon injuries
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CT scan: Used to provide a more detailed image of your injury.
Pain medications such as NSAIDs may be given to you to help you manage the pain. In some cases, orthotic devices may be prescribed to help stabilise the foot.
In severe (and rare) cases of rigid pes planus, surgery is required to correct the deformity and help improve the symptoms.
Your GP may refer you to a physiotherapist for pain treatments and rehabilitation to correct your foot impairments.
What is the recovery time / prognosis for pes planus?
Ultimately, recovery time is dependent on being proactive and seeking professional treatment along with the severity of your foot pain and injury.
Most cases of foot pain resolve on their own after a few days by resting.. However, unless you treat the actual dysfunction of the arches of the foot, pain and discomfort can occur again.
Physiotherapy can improve the outcome for non-rigid pes planus. After two weeks of treatment, you can gradually see an increase in the foot arch and a reduction of your symptoms.
Important factors in recovery include:
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Sticking to your treatment program and regularly exercising
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Resuming your sports activity gradually
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Paying attention to pain, and resting as necessary.
Can pes planus be prevented?
If you were diagnosed with flat feet as a child, there isn’t much you can do to prevent this occurring. However, as an adult there are certainly things you can do to minimise the risk.
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Stay healthy – diabetes and obesity can increase your risk of having flat feet.
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Pace your activity – pes planus can be acquired through overuse injuries.
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Stretch frequently – stretching allows your muscles to relax and prevent stiffness. Stretch your foot, Achilles tendon, and calf muscles often to have optimal tension on your foot arch.
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Strengthen your muscles – include strengthening exercises for the muscles and tendons of the foot to add stability to your foot arches.
Outlook and the main takeaways
Pes planus can be caused by genetics or it can be acquired. It significantly affects the balance of weight distribution on your foot, leading to other problems and injuries.
Generally, rest and pacing your activity can help you deal with pes planus. However, proper foot arch rehabilitation is required to treat the root cause of your symptoms. Book a visit to a physiotherapist today and start your recovery.
Anatomy of the foot arch
There are three arches found on the foot that are formed by the tarsal and metatarsal bones.
The shape of the arches allows them to act as a spring that will enable distribution of weight around the foot and shock absorption. Their unique anatomy facilitates optimal walking and running mechanics.
These arches are supported by various ligaments and muscles that add stability and strength to the structures of the foot arches.
Muscles:
Ligaments:
However, injuries to these ligaments or muscle tears can result in the collapse of the foot arches causing it to contact the ground and lose its support to the foot.
