Flat feet:

A flat foot is the loss of the medial longitudinal arch of the foot.  The deformity is usually asymptomatic and resolves spontaneously in the first decade of life or occasionally progresses into a painful, rigid form that causes significant disability. All at birth have flat feet, and noticeable foot arches are seen at around the age of 3years. Flat foot is more prevalent in children, and females are more predisposed to this condition than their male counterparts in adulthood.

Characteristics/ Clinical presentation

• The major symptom of flat feet is foot pain due to strained muscles and connecting tissues
• Some individuals with flat feet have inwards turned ankles with most of the weight-bearing on foot deviated medially.
• Stiffness of one or both arches of the feet.
• Contractures of feet and ankle muscles in the lateral compartment
• Uneven distribution of body weight with resultant one-sided wear of shoes leading to further injuries.
• Difficulty in walking

 Risk factors for the development of flat feet

• Diabetes and obesity are also factors related to flat feet
• Foot and ankle injury such as rupture or dysfunction of the posterior tibial tendon
• Genetic malformation such as Down syndrome and Marfan syndrome
• Familial factors
• Arches weakness due to overuse and certain forms of foot condition or injuries
• Some medical conditions such as arthritis, spina bifida, cerebral palsy, Arthrogyroposis, and muscular dystrophy. 
• Flat feet can also occur as a result of pregnancy 

Physiotherapy management:

The aim of physiotherapy is to minimize pain, increase foot flexibility, strengthen the weak muscles, and educate patients to prevent any injury.

Pain management can be maintained through activity modification, thermotherapy, massage, Electrical stimulation and ultrasound. Electrical stimulation will increase blood circulation and prompting the healing process, and decreasing discomfort and edema.

Flexibility exercises are consist of passive ROM exercise of the ankle and all foot joints; including Stretching of gastrocnemius soleus complex and peroneus brevis muscles to facilitate varus and foot adduction

Foot Orthotics:

Foot orthotics such as shoe inserts are used to support the arch for foot pain. . Custom orthotics can be prescribed from a registered chiropodist and physiotherapist, and it helps to correct the foot and ankle biomechanics, as well as prevent the arch from collapsing, reducing strain along the heel and plantar fascia.