Pes plano-valgus (fallen arch)
This condition may be either congenital or develop in middle age. This would involve loss of the long arch of the foot, along with loss of the transverse arch at the base of the toes. There would also be an increase in the width of the forefoot and valgus (turning out) of the heel.
• pain in the forefoot with walking
• difficulty getting shoes to fit
• increased discomfort from shoes that were previously comfortable
• tenderness to touch on the bases of the toes (metatarsals)
• flattening of the plantar surface of the foot
If there is forefoot pain then an x-ray should be done to rule out a stress fracture. Also changes in the joint i.e. arthritis should be excluded.
Conservative management should aim to restore foot posture. It is important to do this as the position of your foot greatly affects the rest of your body and thus may cause problems e.g. back pain over time. Your physiotherapist may be able to help by providing you with exercises to strengthening the muscles that provide support to your foot and hold the arches of your foot as well as provide treatment for any foot pain arising due to the flattening of your arches.
Otherwise management would involve your podiatrist who would provide you with the appropriate external supports (orthotics) to restore your foot posture thus minimising any pain. Your podiatrist would also educate you about appropriate footwear.
If conservative management fails then your doctor may refer you to a specialist for surgery.