Flat feet series popular science - How does flat feet form? What are the symptoms?

When it comes to the cause of a disease, there are often both congenital and acquired factors. Flat feet are no exception. Are flat feet more congenital or acquired? Congenital or acquired factors can lead to varying degrees of muscle, tendon or ligament dysfunction and abnormal bone structure in the ankle, which can make it impossible to maintain the normal physiological structure of the arch of the foot, and eventually cause the arch of the foot to collapse and form flat feet. In the previous chapter, the author made a simple summary of the relevant content. In order to let readers understand the causes of flat feet in more detail, the author will summarize the causes of flat feet and push them to everyone in easy-to-understand popular science articles. I hope it will be helpful.

[Causes of flat feet]

1. Congenital flat feet

Genetic factors: If one or both parents have flat feet, it may be passed on to their children.

Developmental deformity: tarsal synostosis (the tarsal bones include the calcaneus, talus, navicular bone, cuboid bone and 3 cuneiform bones). The tarsal bones are short bones that make up the posterior half of the foot, and there are 7 of them in total. Tarsal synostosis is a rare skeletal developmental deformity, characterized by the abnormal fusion of two or more tarsal bones that were originally independent, resulting in a significant decrease in the joint mobility between the tarsal bones or even a complete disappearance. In congenital flat feet, tarsal synostosis is a more common cause, among which the calcaneotaltarsal synostosis and the calcaneonavicular tarsal synostosis are more common. Other tarsal synostosis, such as the talonavicular synostosis, the calcaneocuboid synostosis, the navicular cuboid synostosis, and the navicular cuneiform synostosis are relatively rare.

Developmental malformation: Accessory navicular bone. The navicular bone is one of the seven tarsal bones of the foot. The accessory navicular bone is a congenital abnormality characterized by the formation of an additional, independent bone structure, the accessory navicular bone, at the tuberosity of the navicular bone. Under normal circumstances, the posterior tibial tendon passes "under" the medial surface of the navicular bone, but the presence of the accessory navicular bone forces the posterior tibial tendon to pass "above" the medial surface of the accessory navicular bone and to attach to the accessory navicular bone more firmly. This change destroys the function of the posterior tibial tendon to lift the longitudinal arch of the foot and invert the foot.

Developmental malformations: Congenital vertical talus can be divided into bony malformations and soft tissue lesions.

Bony deformity: The navicular bone forms an abnormal articulation with the dorsal aspect of the talar neck, causing the talus to be fixed in a vertical position.

Soft tissue lesions: including contracture of the tibio-navicular ligament and dorsal talonavicular ligament, stretching and relaxation of the calcaneonavicular ligament, contracture of the extensor digitorum longus, extensor hallucis longus, tibialis anterior, peroneus longus and brevis and Achilles tendon, and the peroneus longus and tibialis posterior tendons moving to the front of the ankle to act as dorsiflexors, etc.

2. Acquired flat feet

Posterior tibial tendon dysfunction. Acquired flat feet are usually caused by foot trauma, disease or chronic strain, which damage the foot bones and the ligaments and muscles that maintain the arch of the foot. The posterior tibial tendon is like a suspension cable of a bridge, maintaining the normal shape of the arch of the foot. If the posterior tibial tendon becomes inflamed or degenerates, the height of the arch of the foot will gradually collapse.

Bone and ligament injuries, such as soft tissue injuries of the foot, fractures, or fractures accompanied by ligament injuries, etc.

Pathological destruction of foot bones and joints, foot bone diseases such as rheumatoid arthritis, bone and joint tuberculosis, etc.

Patients with neuromuscular diseases and poliomyelitis (also known as infantile paralysis) may be left with flat feet, varus and valgus deformities, etc. after the imbalance of internal and external muscle strength of the feet.

Functional injuries, long-term weight-bearing standing, weight gain, pregnancy, and excessive fatigue caused by long-distance travel can gradually weaken the soft tissues such as muscles, ligaments, joint capsules, and aponeurosis that maintain the arch of the foot, causing the arch of the foot to gradually flatten. Long-term illness and bed rest, lack of exercise, can lead to muscle atrophy and weakened muscle tension, which can cause the arch of the foot to collapse when bearing weight.

Degeneration and flat feet can also occur with age. As age increases, the posterior tibial tendon gradually degenerates and it becomes increasingly difficult to maintain the arch structure, leading to flat feet. This situation often does not require special treatment.

【Clinical symptoms of flat feet】

Most flatfoot patients do not show obvious symptoms, but a few may experience pain in the ankles and lower calves, often accompanied by abnormal standing posture and walking gait.

Typical symptoms: pain in the inner side of the midfoot, extending to the inner side of the ankle and calf, aggravated by heel lifting (lifting the heel), standing or walking for a long time, and relieved by rest. Patients may also experience symptoms such as heel eversion when standing, fullness of the inner edge of the foot, flattening or even disappearance of the longitudinal arch of the foot, and protrusion of the navicular tubercle to the inside. Gait may also be abnormal, such as outward-turned gait, which will cause the inner edge of the heel of the patient's shoes to wear easily. In addition, walking or exercise ability may also decrease.

Accompanying symptoms may include swelling of the foot and ankle joints, or hallux valgus, heel valgus or X-shaped leg deformity of the knee joint.

Since patients with early or mild symptoms of the disease have no obvious symptoms of discomfort, it has not attracted the attention of medical staff. Of course, the awareness rate is also low, which leads to the gradual development of children, especially those who go to the hospital for treatment only after the symptoms such as foot deformity, foot pain, and walking difficulties appear; the opportunity for early brace correction is lost. In recent years, under the policy guidance of the country's vigorous advocacy of a healthy China, more and more attention has been paid to the health of the whole people, including the screening and blocking of various congenital diseases before birth, etc. If parents find that their children may have flat feet, they should also go to the hospital for diagnosis in time. In general, doctors only need to observe the patient's foot condition and ask about the medical history to make a diagnosis. Sometimes some imaging examinations are also needed. In short, if there is discomfort in any part of the body, please see a professional doctor in time and follow the doctor's advice for prevention and treatment. (Pictures from the Internet, if there is any infringement, please contact and delete).