Flat feet are called flattening of the arches of the feet with partial loss or complete loss of its shock-absorbing function. There are several types and degrees of the disease. This division is necessary to select the correct treatment. For example, grade 2 flatfoot can still be corrected using conservative methods, but for grade 3 flatfoot, surgery is the main type of treatment.
The longitudinal form of the disease is a flattening of the longitudinal arches of the feet, and the transverse form is a flattening of the forefoot. In the combined version, two types of deformation are simultaneously present.
The frequency of this form is approximately 20% of all cases of the disease. Most often, longitudinal flatfoot is static and develops as a result of weakness of the muscles of the legs and feet, as well as the ligamentous apparatus. This leads to a decrease in the height of the internal longitudinal arch, while the heel bone rotates inward, and its tendon moves outward. A strain in the peroneal tendons is associated with a strain in the tibialis anterior muscle. The appearance of the feet changes. They lengthen, expanding in the middle part. The longitudinal arch drops, the feet are turned inward. The navicular bone can be seen protruding through the skin of the inner edge of the foot. The patient's gait becomes clumsy; when walking, he excessively spreads his toes to the sides.
The prodromal stage (pre-disease) is characterized by the appearance of foot fatigue after prolonged static loads. There may also be pain in the muscles of the legs and in the upper part of the arches. In the stage of intermittent flatfoot, pain in the legs and feet becomes more pronounced towards the end of the day; they also appear during prolonged walking, especially in high heels. Muscle tension occurs, and sometimes temporary contracture of the muscles of the lower leg and foot develops. The longitudinal arches become flattened in the evening, but after rest they return to their normal shape.
Advice: if your profession involves standing for long periods of time, then from time to time to reduce pain in the feet in the initial stages of flat feet, you need to unload the muscles of the arch. To do this, you need to stand for a while on the outer edges of your feet. In the evening, warm baths are recommended to reduce pain.
When the arch of the foot loses its ability to recover, the flat foot stage occurs. At this stage, pain and a feeling of tension develop after minor static loads on the feet. Painful sensations become permanent and can bother you even at rest. At this stage, changes in gait become noticeable.
The last 3rd degree of flatfoot is characterized not only by significant deformation of the foot, but also by other disorders of the musculoskeletal system. This can be osteochondrosis, intervertebral hernia, arthrosis of the joints of the lower extremities, scoliosis. The third degree of flat feet makes it impossible to play sports and causes difficulties in moving even in everyday life.
With transverse flatfoot, the transverse arch of the foot becomes flattened, and its front section seems to rest on the heads of all metatarsal bones, whereas normally only on I and V. As a result, the bones of the metatarsals fan out, the first toe deviates outward, and the middle toe is deformed like a hammer. Transverse flatfoot accounts for approximately 75% of cases.
Externally, the big toe is located at a different angle above the second toe. Movement becomes difficult and pain occurs in the joint between the main phalanx of the big toe and the head of the first metatarsal bone, which is explained by the development of osteoarthritis. The mechanism of formation of longitudinal flatfoot is due to the weakness of the plantar aponeurosis. As the load on the metatarsal bones increases, calluses and corns appear on the skin underneath them, and osteochondral growths appear along the inner edge of the head of the first metatarsal bone.
Important: if you feel pain in your feet and notice an outward deviation of the first toe with an increase in the “bone,” be sure to consult a doctor.
The earlier treatment for flat feet is started, the more visible the result will be.
This form of flatfoot ranks third in occurrence after transverse and longitudinal. Longitudinal-transverse or combined flatfoot is a simultaneous flattening of the longitudinal and transverse arches of the foot.
This is a rare form of flatfoot, which is most often represented by flattening of the longitudinal arch and pronation of the foot (planovalgus foot). The reason is congenital inferiority of the ligaments, muscles and bones of the foot. To treat this form of the disease, plaster casts are applied to the child from the first days of life, orthopedic shoes are subsequently used, and massage and therapeutic exercises are widely used.
This type of flatfoot occurs after fractures or other injuries to the bones of the foot (tarsal, metatarsal, calcaneus) and ankles. This usually happens when fractures heal incorrectly, so in case of severe flat feet, surgical treatment is preferred.
Static loads are the most common cause of flat feet. Factors predisposing to the occurrence of static flat feet are the following:
Diagnosis of flat feet is based on analysis of complaints, external examination and palpation of the feet. The diagnosis is clarified using x-ray examination. When analyzing the radiograph, the degree and stage of flat feet are determined. A simple way to guess the degree of flatfoot is a plantogram. For this test, the patient's foot is smeared with a harmless dye and an imprint of the foot is made on clean paper while standing. The extent of the disease can be judged by the outline and shape of the print. It is also important to find out the cause of flat feet; for this patient, you need to ask in detail about work, what kind of shoes he usually wears, etc.
It is especially easy to detect valgus flatfoot during examination, when the first toe deviates significantly outward and overlaps the second.
Important: when contacting a doctor, be sure to tell about previous injuries to the lower extremities, as well as infectious diseases and rickets in childhood.
I have third degree flat feet, doctors discovered this about 15 years ago. The most interesting thing is that I am on my feet for 12 hours at work and everything is fine. I don’t feel any discomfort or pain at all. True, there is one thing: I always buy expensive, high-quality shoes! But I can’t walk for a long time in a cheap one; my legs start to hurt after an hour.