Chiropractic Fixes for Flatfeet

While you may have heard the term “flatfoot” used as a mildly disrespectful reference to police officers, having “flatfeet” or being “flatfooted” is a common foot condition. Although most flatfoot people have little to no symptoms and normal foot function, for some, it causes pain and discomfort, particularly after activities or with shoes lacking proper arch support. When pain arises, several treatments—including those from chiropractors—are available.

What Exactly Is Flatfeet?

“Flatfoot” is a general term for several complex foot disorders that involve a partial or complete collapse of the foot’s arch. Having flatfeet—or being flatfoot—is when the arch on the inside of one or both feet stay flattened with pressure. For example, when flatfoot people stand, the feet point outward and the entire sole falls and touches the ground when the foot normally should maintain a definitive arch.

You may be thinking, “My foot does that when I walk. Do I have flatfeet?” By design, “the joints in the foot unlock and become more flexible as the arch drops,” explains Dr. Rick Gross of Quality Care Chiropractic, “but this flexibility is intended to be temporary while walking or running. If the foot stays flattened—as in someone with minimal or no arch—the body loses its stable foundation and much of its power while walking, running, jumping, or biking.”

Dr. Gross adds, “The foot’s tented structure is meant to move and support your body by allowing its 26 bones to flatten and bounce back up into a rigid arch as needed. Because of the various demands we place on our feet, a lot can go wrong, which leads to painful feet.”

What Are the Symptoms of Flatfeet?

Most people with flatfeet have no pain or symptoms; in such cases treatment isn’t necessary. However, some experience swelling along the inside of the ankle and heel or arch pain that worsens with activity. Long-term effects of untreated flatfeet include hip, knee, or lower back pain; aching on the foot’s outside edge; shin splints; inwardly rolling the ankle; and foot and leg fatigue after standing or walking. “A collapsed arch also can lead to bunions, hammer toes, Morton’s neuroma, plantar fasciitis, and other painful foot conditions,” says Dr. Gross.

Who Can Get Flatfeet?

Flatfeet happens in both children and adults because it can be congenital or onset with aging and stress.

Pediatric Flatfoot. Flatfeet is not unusual in infants and toddlers because the foot’s arch hasn’t yet developed. Children can have flexible (meaning they mature out of it) or rigid fixed flatfeet conditions, but even this may not show symptoms until the foot bones start maturing around ages 9–15. Some have a condition called tarsal coalition in which the foot is permanently fixed in a flat position with its two rear bones fused together, which inhibits mobility. Flatfeet children may experience foot pain or discomfort during exercise and may withdraw from physical activities because fallen arches often cause knees and legs to rotate inward, leading to foot, back, and knee problems.

Adult-Acquired Flatfoot. People born without flatfeet can develop it overtime if one’s arches never form or if they collapse from an injury or long-term wear and tear that is made worse with aging, obesity, or medical conditions like rheumatoid arthritis or diabetes. Over time, the arch-supporting tendon along the inside of the ankle weakens or tears; after years of abnormal strain, it begins to collapse the arch. A collapsed arch can go rigid, keeping the foot “stuck” in a flat position, and, as severity increases, arthritis also can develop.

What Causes Flexible Flatfeet?

Flatfoot is caused by various abnormalities related to the tendons, the arch, or bone deformities.

Tight Tendons. A tight Achilles tendon and/or calf muscle contributes to flatfeet. This tightness brings the heel off the ground too early when stepping, which changes the gait and increases arch pressure, thereby collapsing foot alignment. A tight Achilles tendon from birth puts inordinate pressure on the foot’s front and prevents normal formation of a springy arch.

Pronation. This is when the foot rolls inward, causing the arch to flatten. Too much pronation, leading to flatfoot, can be painful.

Bone Deformities. A rigid, inflexible flatfoot, with no arch regardless of activity, typically is caused by bone malformations, deformities, or fusions preventing the arch from forming. It can be present from birth or acquired in adulthood from a foot injury or disease. This often causes more symptoms because the foot’s biomechanics are altered.

What Are Treatments for Flatfeet?

A flexible flatfoot diagnosis with no symptoms may not need treatment, but if flatfeet is causing you pain and limiting your activities, several tiers of treatments are available.

Conservative. Most flatfoot cases can be treated conservatively with the aim of relieving discomfort.

• Pain Medications. Pain relievers, such as ibuprofen, can ease inflammation and soothe achy feet.
• Supportive Shoes. Wearing well-fitting shoes with a firm sole and good arch support provide benefits and relief for pain in the feet, legs, and back.
  - Comfort. Seek out comfortable walking or athletic shoes with substantial arch support, room for your toes, a firm heel counter, and a flexible sole.
  - Heel Height. Completely level shoes put too much pressure on the heel, so wear shoes with an elevated heel of about ¼" or ½". Avoid shoes with heels higher than 2¼" inches because that shortens the Achilles tendon.
  - Proper Fit. Get fitted for shoes by a trained salesperson later in the day because your feet are at their largest (from swelling and slight arch compression).
• Orthotic Inserts. Although they don’t reverse structural foot deformities or reconstruct arches, semi-rigid shoe inserts support the arch to promote better biomechanics as well as provide cushioning and shock absorption to reduce potential problems throughout the body.
  
  - Off-the-Shelf. Inserts can be bought in the store if you’re looking for additional padding or support.
  - Custom-Made. If you have flexible flatfeet (not rigid) and stand or walk a lot, consider custom-made orthotics. Some health insurance plans cover them, and they can be obtained from podiatrists as well as osteopaths, physicians, chiropractors, and physiotherapists.
  - Chiropractic Recommendation. “The best orthotics we have found,” offers Dr. Gross, “are made by Sole Supports (www.solesupports.com). Many shoe inserts simply cushion or tilt the foot to comfort the bones and ligaments during abnormal motion. Sole Supports, on the other hand, support the foot before you even start moving, so much of your motion becomes normal. The brand is fully customized to each patient and fits the foot and shoe so well that every one of our patients—even people who had severely painful and tender feet before having them—prefer to wear Sole Supports all the time.”
• Custom Bracing. In cases of tendon tear or severe arch collapse, custom bracing combines orthotic foot and ankle support.
• Modifying Activities. You should keep moving and doing what you want, but you may need to cut back on activities that cause pain. Recreational runners or walkers should talk to a specialist about modifying their exercise routine. If you stand or walk for several hours each day, take frequent breaks to rest your arches.
• Losing Excessive Weight. Overweight or obese people may find relief with weight loss because excessive weight puts pressure on the arches (e.g., one pound of belly weight adds 12 pounds of weight on the foot).
• Physical Therapy. Physical therapists use ultrasound or other techniques to help with pain from flexible flatfeet caused by weak or tight tendons. Wrapping the foot with sturdy tape can provide a temporary, artificial arch. They also can tailor stretches and strengthening exercises to your feet, tendons, and calf muscles to help restore arch function.

Surgical. When conservative treatments cannot stop severe discomfort, surgery is an option, but it should be considered with caution because of the impact. Potential surgeries to fix alignment include bone removal, tendon repair (shortening or lengthening), or joint fusion. Notably, surgeons operate only on one foot at a time to avoid complete patient incapacitation, and recovery times vary by procedure but can last several months. Complications include failure of fused bones to heal, infections, reduced range of motion, and chronic pain.

Regenerative. Regenerative medicine options dramatically decrease the need for surgery by increasing the body’s ability to heal damaged tendons or ligaments.

• Platelet-Rich Plasma Therapy. A mainstay in treating tendon injuries, this involves platelet material being drawn from the patient’s blood. Growth factors in the blood are then injected near the damaged tendon.
• Amniotic Stem Cell Injection. Amniotic cells help increase the growth factors necessary for healing. When injected near the damaged region, the body brings additional healing cells to the area.
• Bone Marrow Stem Cell Therapy. Bone marrow cells heal all damaged body tissue. A concentrated injection of bone marrow near the damaged arch allows the body to self-heal.

Chiropractic. When conservative treatments aren’t working, and the thought of surgery or regenerative injections gives you pause, a noninvasive yet effective alternative is chiropractic treatment.

Dr. Gross attests, “As we apply specific chiropractic foot adjustments, the joints and ligaments get retrained to work much more effectively and get into the proper positions for foot function. Most foot conditions can become pain free and even resolve after a series of proper foot adjustments by a Chiropractic Hand and Foot–trained chiropractor. If the foot still needs additional support, we use a specific foot orthotic, like Sole Supports, to help support the arch.”

If you have any questions or think your foot, leg, or back pain may be caused by flatfeet, contact us at Quality Care Chiropractic in Aurora, IL, at (630) 499-2225 to learn more so we can help get you back to whole-body health.

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