Flat Foot (Pes Planus)
Flat foot is a condition where the medial longitudinal arch of the foot is lowered or absent, causing the entire sole to touch (or nearly touch) the ground when standing. It can be flexible (arch appears when not weight-bearing) or rigid (arch absent even when non–weight-bearing).
🔹 Causes / Risk Factors
-
Congenital (present from childhood).
-
Ligament laxity.
-
Weakness of intrinsic foot muscles or tibialis posterior.
-
Obesity → increased load.
-
Trauma or posterior tibial tendon dysfunction.
-
Aging (degenerative changes).
-
Improper footwear.
🔹 Types
-
Flexible Flat Foot → arch visible when non–weight-bearing but flattens on standing.
-
Rigid Flat Foot → arch absent in both weight and non–weight-bearing (often more serious).
🔹 Symptoms
-
Some cases are asymptomatic.
-
Foot pain (especially in the arch or heel).
-
Fatigue after prolonged standing or walking.
-
Swelling along inside of ankle.
-
Altered gait mechanics → knee, hip, or low back pain.
-
Shoes wear out unevenly.
🔹 Diagnosis
-
Observation (arch collapse on standing).
-
“Too many toes” sign (forefoot abduction).
-
Functional tests: heel rise test (inability to form an arch may indicate tibialis posterior dysfunction).
-
Imaging: X-ray, MRI (if associated with tendon problems).
🔹 Management
Conservative (first-line):
-
Physiotherapy:
-
Strengthening exercises for intrinsic foot muscles & tibialis posterior.
-
Stretching tight structures (Achilles tendon, gastrocnemius).
-
Balance and proprioception training.
-
-
Footwear & orthotics:
-
Arch supports (insoles, medial wedges).
-
Supportive shoes.
-
-
Activity modification (avoid prolonged standing on hard floors).
-
Weight management.
Surgical (for severe / rigid / symptomatic cases not responding to conservative care):
-
Tendon repair or reconstruction.
-
Osteotomy (bone realignment).
-
Arthrodesis (fusion, for severe deformity).
🔹 Exercises (Home Program Examples)
-
Towel scrunches → curl toes to grip towel.
-
Marble pickups with toes.
-
Calf stretches (against wall).
-
Heel raises → strengthen calf & posterior tibialis.
-
Short foot exercise → draw arch upward while keeping toes relaxed.
--------------------------------------🔹protocol of treatment
 Flat foot is a condition where the medial longitudinal arch of the foot is lowered or absent , causing the entir…){kind=link}
أزال المؤلف هذا التعليق.
ردحذف