Pes Planus

Alternative names for Pes Planus include flat feet, fallen arches, pes planovalgus, excessively pronated feet. Flexible flatfoot, collapsing pes valgus.

Pes Planus is a common foot condition where more of the plantar surface or foot plane is in contact with the ground than normal as the result of a decreased or absent longitudinal arch. The arch develops in childhood and by adulthood one in seven adults has flat feet and for many people flat feet is a variation of the normal and do not cause pain or other problems.

Subjective findings for pes planus include flattening of the foot arches, difficulties in fitting shoes, rapid wear of shoes  at the medial aspect and heel.

Objective findings include little to no longitudinal arch, little or no transverse tarsal arch, abnormal pronation with weight bearing, eversion of the rear foot in stance and gait, ankle equinus deformity due to a tight Achilles tendon. Hallux Valgus, bunions, Tailor’s bunions and toe deformities may also be present.

Pes Planus is characterized by one or more of the following, abnormal pronation, heel valgus in resting calcaneal stance, medial column collapse, forefoot abduction and inversion from a slightly supinated position,  or ankle equinus,  where  the Achilles tendon is shorter than needed to allow adequate dorsiflexion during the gait cycle.

There are two basic types of pes planus, flexible and rigid. Most flat feet are flexible and an arch appears when the person stands on their toes.

Rigid or stiff inflexible flat feet and usually require surgical treatment.  Peroneal spastic flat foot is most commonly associated with tarsal coalition where one or more joints in the foot fail to form properly or as a result of arthritis, infection ,trauma or tumors. Acquired pes planus can be caused by arthritis , infection, and trauma. Neuropathic joint disease leads to painless rigid pes planussometimes caused by diabetes mellitus, leprosy, tertiary syphilis, spina bifida and syringomelia.

A common mimicking condition of pes planus is posterior tibial tendon dysfunction (PTTD) also known as acquired adult flat foot deformity (AAFFD) where the posterior tibial tendon fails in its function function to counter dynamic abduction and eversion of the foot.

Footwear Solutions for Pes Planus

When choosing footwear for Pes Planus it’s important to get a shoe with extended and firm medial counters, which can also accommodate an interior heel wedge or be easily modified for an external heel wedge. Functional orthotic devices with a rear foot posting act on the heel to support in a desired position or move it into a corrected position. A subtalar control foot orthoses or SCAFO can also be worn in a depth shoe to help treat pes planus. Accommodative devices are used for feet with rigid or limited motion that cannot be acted upon by an orthosis to encourage correct biomechanical function or for neuropathic patients that need protection from high vertical forces. Accommodative devices are used as a comfort device to absorb shock and to redistribute pressure away from high pressure points to areas of lower pressure so that the pressure is carried equally across the whole foot.

 

Pedors Productsfor Pes Planus, Flat Feet or Fallen Arches.

 

Option 1) Beats orthotic Posted Heel No Met Pad

The most common  option for pes planus with range of motion.

Option 2)  Beats Posted Heel With Metatarsal Pad

If ball of foot pain or metatarsalgia is present.

Option 3) Pedors 3P Insert.

An accommodative inserts for feet with limited range of motion.

Option 4) None of the above.

A custom molded device is required. Find a Certified Orthotist  (C.O)  or a Certified Pedorthist (C.Ped)  to evaluate your need and make a positive model of the foot by taking a cast of the foot and custom fabricating your device.