Fun Fact: Flat feet where the arch did not correctly develop is caused by wearing closed toe shoes as a child.
Children who can run around barefoot or in sandals do not develop the problem because their feet can develop properly.
Flatfeet also called fallen arches or Pes planus is a condition where there is either no arch to the feet or very little arch. This creates the effect of the total sole into complete or near-complete contact with the ground when standing.
The condition is not an uncommon one, and a large percentage of those who have flat feet do so because the arch of the feet simply did not develop properly. For those lucky few the condition is usually not painful.
Those who have developed rigid flat foot, a condition where the sole is completely flat, from illness or injury may not be so lucky. The development of flat feet as an adult is indicative of another more serious problem and can result in foot pain in the arch.
One such condition that it can lead to is posterior tibial dysfunction. The posterior tibial tendon runs along the heel if the foot and serves as one of the main supporting structures of the foot. Posterior tibial tendon dysfunction or PTTD occurs when changes due to illness or injury change the tendon and impair its ability to support the arch of the feet, resulting in flat feet and severe arch pain.
PTTD is the number one cause in adults and is a progressive illness, so it will continue to get worse if left untreated. You want to see the doctor at the first sign of this problem as it is curable when treated early. PTTD is considered a sports injury as it is caused by over use of the tendon when walking, running, climbing stairs and hiking. The symptoms of PTTD are progressive and include pain, swelling, flattening of the arch of the foot and in severe cases an inward rolling of the ankle.
The first sign of PTTD is a pain on the inside of foot and ankle area. After a while, this will intensify, and the ankle will start to turn in as the arch of the foot begins to fall. The final symptoms are pain along the outside of the foot below the ankle and fallen arches.
Treatment when caught early usually consists of an orthotic device which will immobilize and brace the foot, physical therapy, and anti-inflammatory medications. However, when treatment has been delayed arch pain treatment for this condition may require surgery for flat feet to correct the tendon.
Another cause of a flat arch could be a condition called hyper-pronation. Hyperactive pronation is caused by a hereditary under-development of the ankle bone or the heel bone that causes an unusual range of motion in the ankle. One of the symptoms of this condition is raised or lowered arches in the foot.
Another cause is brachymetatarsia which is a condition where one of the long bones of the foot does not develop correctly and results in a short toe. The condition is caused when the growth plate of the bone closes too early, and the bone fails to grow properly due to genetics or an injury to the foot as a child. There are few treatment options for this condition. Special shoes can help, but the only real treatment is surgery.