You Ask , They Answer
Q
: What are flat feet and how do they develop ?
A
: Pes planus is a foot and ankle condition that is commonly known as flat feet .
This condition usually develops in early adolescence and has the potential to worsen in severity over the years , often precipitated by a combination of poor choices of footwear , development of muscular or tendon tightness , and degeneration in other areas of the ankle .
Q
: Which problems are associated with flat feet and do patients always require treatment ?
A
: The condition of flat feet often presents on a continuum or a spectrum of varying severities .
In patients with a tendency to have low arches , this often is asymptomatic and all that is required is usually attention to muscular stretching of the calf muscles , carrying out tendon strengthening exercises , and the use of insoles to support the arch .
In children below the age of 10 with low arches , this is physiological and oftentimes parents need not worry too much unless of course the occurrence is associated with pain and an abnormal gait pattern .
A period of observation till early teens is usually advised for children . In symptomatic children with low arches or flat feet that do not respond to using insoles and physiotherapy , further investigations , including MRI , may be advised with a view to oftentimes minimally invasive surgery to correct flat feet and relieve pain .
Q
: What are the treatments available for them ?
A
: In adults with flat feet who do not respond to therapy and the use of insoles and have worsening pain in areas of the ankle especially on the inner aspect , investigations may be required to check foot alignment and tendon quality .
Oftentimes , treatment is focused on biomechanical correction for foot alignment as well as pain relief by relieving the areas of inflammation with a combination of injections , tendon strengthening measures , and , in severe cases , surgical correction of the deformity .
Q
: Can the condition be prevented ?
A
: In many cases , flat feet runs in families , and what is inherited is the tendency for developing ligamentous laxity which is almost always present in patients with flat feet . However , this tendency to develop flat feet can be altered by wearing proper shoe insoles and focusing on strengthening exercises from young .
Dr Anandakumar Vellasamy
Dr Anandakumar Vellasamy is an orthopaedic specialist surgeon at Farrer Park Hospital . He performed the first lateral total ankle replacement surgery in Southeast Asia for end-stage ankle arthritis .
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