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Everyone is born with flat feet, however by the age of four part of the foot rotates and changes your foot position. After this point, if your foot has not corrected its position you will always have flat feet. Severe or marked cases are often noted in early childhood, but more subtle cases are often not noted until early adulthood or after an increased level of activity/sport. Flat feet can also occur after trauma.
A calcaneal spur, or ‘heel spur’, is a pointed bony outgrowth on the heel bone (the calcaneus bone) formed from calcium deposits. Heel spurs can be located at the back of the heel or under the heel, and cause tenderness and pain at the back of the heel made worse while pushing off the ball of the foot. This is particularly common in people who do activities which involve strain on the heel, for example running on hard surfaces or jumping.
Plantar Interdigital Neuroma
Otherwise known as Morton's neuroma, a nerve in the foot becomes irritated and thickened, which can cause severe pain, burning, numbness and tingling. The condition typically occurs in only one foot but can affect both feet. It usually affects the nerve between the third and fourth toes, but sometimes the second and third toes are affected. The exact cause of this condition is not known but may develop from chronic stress and irritation of the nerves running between the metatarsals and is linked to flat feet.
One of the most common causes of heel pain, plantar fasciitis presents itself through pain and inflammation of the plantar fascia – a thick band of tissue which connects your heel bone to your toe. The pain is often felt most when you first stand in the morning or after long periods of sitting. This condition is linked to flat footwear with limited support (e.g. ballet pumps) and is also common in runners.
Foot position and overpronation (where, when walking, the ankle rolls too far downward and inward with each step) can cause premature wearing of the medial compartment of the knee joint and malalignment of the whole lower leg. This may cause tendonitis, shin splints and iliotbial band syndrome.
Overpronation of the foot can cause irritation of the bursae (the sac that cushions and protects a tendon) surrounding the head of the hipbone causing pain when moving and when sleeping.
Lower Back Pain
Overpronation of the foot causes internal rotation of the lower limb which tilts your pelvis, increasing the pressure on your lower back. It also reduces your core gluteal strength, which in turn reduces the strength in your legs.
Many children with flat feet, especially children who participated in sport, suffer from early plantar fasciitis, heel pain (such as Servers disease), knee pain or Osgood Schlatters disease which is linked to rapid growth and flat feet/overpronation.
Metatarsal and Inter-metatarsal bursitis
More commonly found in women, bursitis is when a bursa (a small fluid-filled cushioning sac) becomes inflamed or irritated. Bursitis in the foot may occur in several ways. It may present after direct trauma to the foot or, most commonly, is due to irritation from repetitive use and overuse, for example long hours of standing.
Clawed toes may occur from poorly fitting shoes or from nerve damage in the foot (for example because of diabetes or alcoholism). This deformity may become permanent if not treated and presents itself with the toes ‘clawed’ with the toe bending upwards from the joint at the ball of the foot, and then downward at the middle joint towards the sole of the shoe. This may create painful calluses or development of corns around the affected toes.
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