Summary about Disease
Flexible flatfoot, also known as pediatric flatfoot or hypermobile flatfoot, is a common condition in children where the arch of the foot is present when the foot is not bearing weight, but disappears when standing. In most cases, it is painless and resolves on its own as the child grows. However, some individuals may experience pain or functional limitations.
Symptoms
A visible flattening of the arch when standing.
The arch reappears when sitting or when the foot is not bearing weight.
Most children with flexible flatfoot have no pain.
Some may experience:
Pain in the foot, ankle, or leg (especially after activity).
Stiffness in the foot.
Difficulty walking or running.
Tiredness in the feet.
Causes
Ligament Laxity: The primary cause is typically ligament laxity, meaning the ligaments that support the arch are more flexible than usual. This is often a normal variation, especially in young children.
Genetics: There is a genetic component, meaning it can run in families.
Muscle Weakness: Weak muscles in the foot and lower leg can contribute.
Obesity: Excess weight can put extra stress on the arches.
Tarsal Coalition: In rare cases, a bony connection between two or more bones in the foot can restrict movement and cause flatfoot.
Medicine Used
Over-the-counter pain relievers: For pain management, medications like ibuprofen (Advil, Motrin) or acetaminophen (Tylenol) may be used.
Custom or over-the-counter arch supports (orthotics): These can help support the arch and alleviate pain.
Rare cases: If underlying causes, like inflammation, are identified, the doctor might suggest other medications like anti-inflammatories.
Is Communicable
Flexible flatfoot is not communicable. It is not caused by an infection and cannot be spread from person to person.
Precautions
Proper footwear: Wear supportive shoes with good arch support.
Weight management: Maintain a healthy weight to reduce stress on the feet.
Regular exercise: Strengthening exercises for the foot and lower leg muscles can be helpful.
Stretching: Calf stretches can help improve flexibility.
Avoid activities that aggravate the condition: Modify activities if they cause pain.
How long does an outbreak last?
Flexible flatfoot is not an "outbreak" situation like an infectious disease. It is a structural condition. In many children, flexible flatfoot resolves naturally as they grow and their ligaments tighten. This can take several years. For others, it may persist into adulthood.
How is it diagnosed?
Physical examination: A doctor will examine the foot, observe the arch while standing and sitting, and assess the range of motion.
Medical history: The doctor will ask about symptoms, family history, and any other relevant medical conditions.
Gait analysis: Observing the way the person walks can provide information.
X-rays: X-rays may be ordered if there is pain, stiffness, or suspicion of a bony abnormality (like tarsal coalition).
Timeline of Symptoms
Infancy/Early Childhood: Flat feet are common in infants and toddlers due to ligament laxity.
Childhood: As children grow (around ages 3-10), the arch typically develops. However, in flexible flatfoot, the arch only appears when not weight-bearing.
Adolescence/Adulthood: In most cases, flexible flatfoot becomes asymptomatic. However, some individuals may experience pain or problems that persist into adulthood. The symptoms can arise at any point in time.
Important Considerations
Most cases are benign: Flexible flatfoot is usually a normal variation and doesn't require treatment if it's not causing pain or functional problems.
Referral to a specialist: If pain persists despite conservative treatment, or if there are other concerning symptoms, a referral to a podiatrist or orthopedist may be necessary.
Monitor for progression: It is important to monitor the condition over time and seek medical attention if symptoms worsen.
Treatment is individualized: The best treatment approach depends on the severity of symptoms and the individual's needs.
Tarsal coalition needs surgical intervention: If the underlying cause of flatfoot is tarsal coalition surgery may be required.