A fallen arch, also known as pes planus or flatfoot, describes a common condition where the arch of the foot collapses, causing the entire sole to make contact or nearly contact the ground. This alteration in foot structure can affect one or both feet. While some individuals with fallen arches experience no symptoms, others may encounter discomfort and changes in foot mechanics.
Understanding Fallen Arches
Fallen arches involve the flattening of the medial longitudinal arch, which is the inner arch of the foot. This collapse often results from the stretching or weakening of the ligaments and tendons that support this arch, particularly the posterior tibial tendon. This tendon helps maintain the arch and enables foot movement.
Several factors can contribute to the development of fallen arches. Genetics can play a role, as some individuals are predisposed to flatter arches from birth. Aging is another common cause, leading to natural wear and tear on the body’s joints, tendons, and ligaments. Injuries to the foot or ankle, such as fractures or ligament damage, can undermine arch support. Medical conditions like posterior tibial tendon dysfunction (PTTD), where the posterior tibial tendon weakens or becomes inflamed, are frequently associated with acquired flatfoot. Other contributing factors include obesity, diabetes, and certain types of arthritis.
Non-Surgical Solutions for Arch Support
Addressing fallen arches often begins with non-surgical approaches aimed at strengthening foot muscles, providing external support, and improving overall foot mechanics. A comprehensive plan typically incorporates specific exercises, appropriate footwear, and supportive devices.
Specific Exercises and Stretches
Targeted exercises can help strengthen the intrinsic muscles of the foot, which are important for maintaining arch integrity. One effective exercise is the “towel curl,” where you sit with your feet on a towel and use your toes to scrunch the towel towards you, engaging the small muscles in the foot. Another beneficial activity is the “marble pickup,” which involves using your toes to pick up small objects like marbles and place them in a container, enhancing toe dexterity and strength. Calf raises also contribute to foot and ankle strength, as tight calf muscles can influence arch height.
Orthotics and Arch Supports
Orthotics are custom-made or over-the-counter inserts worn inside shoes to provide support and improve foot alignment. Custom orthotics offer precise support and redistribute pressure evenly. They can help to correct biomechanical imbalances and alleviate pain by supporting the collapsed arch. Over-the-counter options can offer some cushioning and general arch support, though they may not provide the same level of personalized correction as custom devices.
Appropriate Footwear
Choosing the right footwear is important for managing fallen arches. Shoes with good arch support and adequate cushioning can help to distribute body weight evenly and absorb shock. Supportive shoes often feature a firm, structured midsole to mimic the function of a natural arch. A stable heel counter, which is the rigid part surrounding the back of the shoe, helps control pronation (the inward rolling of the foot) and maintain proper foot alignment. A wide toe box can also be beneficial, allowing toes to spread naturally and preventing collapse.
Physical Therapy
Physical therapy assesses individual needs and guides rehabilitation for fallen arches. A physical therapist can develop a personalized exercise program to strengthen specific muscles and improve flexibility. This structured approach can address underlying issues contributing to the arch collapse and help individuals learn proper movement patterns to reduce strain on the feet and lower limbs.
When Surgery is Considered
Surgery for fallen arches is generally a consideration when non-surgical treatments have not provided sufficient relief from pain or when the condition significantly impairs function. It is often viewed as a last resort for severe cases where pain is persistent and daily activities are limited.
The goals of surgical intervention typically involve reconstructing the arch, repairing damaged tendons, or realigning bones to restore proper foot structure. Procedures may include tendon transfers to provide better arch support, osteotomies (cutting and repositioning bones), or joint fusions to stabilize the foot. Consulting with a foot and ankle specialist is important to determine if surgery is appropriate and to understand the specific procedures involved and expected outcomes.
Long-Term Foot Health and Prevention
Maintaining long-term foot health and preventing the worsening or recurrence of fallen arches involves consistent self-care and lifestyle adjustments. These strategies focus on reducing stress on the feet and supporting their natural mechanics.
Managing body weight is an important preventive measure, as excess weight places additional stress on the foot’s arches. Adopting a healthy diet and engaging in regular, low-impact exercise, such as cycling or swimming, can help maintain a healthy weight without overstressing the feet. Continued use of supportive footwear and orthotics, as recommended by a foot specialist, can provide ongoing structural support and help distribute pressure evenly across the foot. Regularly performing foot-strengthening exercises and stretches can also help maintain muscle strength and flexibility, contributing to sustained arch support.