Treatment of the Flat Foot

Image: Personal

The flat foot is a condition that can be seen in children and adults and whose etiology is diverse. Basically there is a loss of the plantar arch, or subsidence of the plantar arch. From birth to 3 years approximately it is normal to find a child flat lax foot, considering that there is still immaturity of the capsuloligamentary apparatus as well as the intrinsic and extrinsic muscles of the foot which begin to be conditioned to master the gait, this is achieved under normal conditions from this age.
It is important to diagnose early this alteration during childhood to start conservative orthopaedic treatments based on the correction of habits such as walking barefoot on the floor, or the use of inappropriate shoes, as well as the execution of a routine of exercises that strengthen the ligaments. and muscles that sustain and form the plantar arch along with the use of orthopaedic shoes whose indication is controversial because there are authors who defend the fact that these do not provide benefits, in my opinion, if they work since they prevent the deformity from progressing this, as long as they are part of a protocol acting as neoadjuvant therapy in conjunction with the exercises.

In severe cases such as in the neurological flat foot of the child, or those cases that have not responded to the conservative method, or in adult patients, among others, the treatment consists of restoring the plantar arch, normalizing the altered anatomy through various techniques such as subtalar arthrorrisis with endoprotesis, osteosynthesis material, and in more advanced cases (flatfoot grade 3-4) arthrodesis is suggested.

Below I describe some of the recommended exercises to favor the formation of the plantar vault during childhood. They should be done at least twice a day:
-Walk on tiptoe.
-Walk with heels support.
-Walk with the outer edge of the foot.
-Perform squats.
-Try to take small objects with the toes.

Here some exercises

Image: Personal

Regards!! Dr. Soanna Vilchez

References:

• Herring JA. Tachdjan´s Pediatric Orthopaedic. Philadelphia: Ed. Saunders - 3rd ed., 2002.
• 20 Lecciones de Patología del Pie, A. Viladot. Ed. Mayo, 2009