Pes planus seldom produces any signs and symptoms. In cases when it does, pain is the most common complaint. In addition, the other symptoms include the following:

• Feet begin to ache after long hours of standing or after playing sports.
• Children often complain of pain in the ankle, foot and the lower leg [7].

• Severe Pain

  Abstract Flatfoot is a foot condition caused by the collapse of the medial arch of the foot, and it can result in problems such as severe pain, swelling, abnormal gait, and difficulty walking. [ncbi.nlm.nih.gov]

  Reconstructive surgery of the foot is very complex and requires a long recovery period; this procedure is reserved for the rare cases of severe, painful flat feet that don’t respond to conservative measures such as shoe inserts, stretching and strengthening [luriechildrens.org]

  Flatfoot may cause congestion of the muscles of the feet, which can cause severe pain in the muscles of the foot and/or calf. Pain most often develops during the day, sometimes with swelling in the foot. [alignfootwear.co.uk]

  For the rare cases when surgery is needed, doctors at Seattle Children’s developed the most common operation now used nationally to correct severe, painful flatfoot with short Achilles tendon in adolescents. [seattlechildrens.org]

  Severe pain, rapid swelling, and bluish-skin coloring affect the area below the blocked vein. Continued clotting can lead to increased swelling. The swelling can interfere with blood flow. This complication is called phlegmasia alba dolens. [medlineplus.gov]

• Weight Loss

  Weight loss. If you are overweight, try to lose weight. Putting too much weight on your arches will aggravate your symptoms. Orthotic devices. Use orthotic devices in your shoes to support to the arches. Immobilization. [valleyfootanklecenter.com]

• Lower Extremity Pain

  Alteration of foot biomechanics such as with pes planus, may play a role in the development of lower extremity pain with exercise 18. [ncbi.nlm.nih.gov]

• Difficulty Walking

  Abstract Flatfoot is a foot condition caused by the collapse of the medial arch of the foot, and it can result in problems such as severe pain, swelling, abnormal gait, and difficulty walking. [ncbi.nlm.nih.gov]

• Nausea

  He also denies nausea, vomiting, chest pain, shortness of breath, calf pain or any other symptoms. His past medical history reveals hypertension and hypercholesterolemia. [podiatrytoday.com]

• Vomiting

  He also denies nausea, vomiting, chest pain, shortness of breath, calf pain or any other symptoms. His past medical history reveals hypertension and hypercholesterolemia. [podiatrytoday.com]

• Abdominal Pain

  Abdominal syndrome 30. Pulmonary embolism - Clinic The classic presentation of pulmonary embolism is the abrupt onset of pleuritic chest pain, shortness of breath, and hypoxia. [slideshare.net]

• Hypertension

  Known risk factors for the condition include obesity, hypertension and diabetes. [sciencedaily.com]

  It can also be acquired over time, caused by conditions such as rheumatoid arthritis, stroke, diabetes, obesity, hypertension, or from simple wear and tear stresses of age that weaken the tendon that runs along inside of ankle and helps support your arch [limbionics.com]

  Other risk factors include having obesity, hypertension, and diabetes mellitus. There’s no cause for concern if your feet are flat and you have no pain. [healthline.com]

  His past medical history reveals hypertension and hypercholesterolemia. His past surgical history consists of a cholecystectomy and previous open reduction internal fixation for his left wrist. [podiatrytoday.com]

• Foot Pain

  While improvement in terms of foot pain, foot function index and quality of life was observed in all the study groups (p< 0.05), the most improvement was observed in the group of patients treated with internal modification (p< 0.016). [ncbi.nlm.nih.gov]

  Pain may worsen with activity. Swelling along the inside of the ankle can also occur. When to see a doctor Talk to your doctor if you or your child has foot pain. [mayoclinic.org]

  Symptoms associated with fallen arches may include: Persistent foot pain not related to any other conditions Arch or heal pain that worsens with strenuous activities Visible swelling on the inside part of the ankle Diagnosing Pes Planus If the “wet foot [theshoesforme.com]

  […] of foot pain and foot problems such as: [ 1 ] Tibialis posterior dysfunction (because hyperpronation stretches this tendon). [patient.info]

• Foot Deformity

  FDA-regulated Device Product: No Keywords provided by Ju Seok Ryu, Seoul National University Hospital: Additional relevant MeSH terms: Layout table for MeSH terms Flatfoot Talipes Foot Deformities, Acquired Foot Deformities Musculoskeletal Diseases Foot [clinicaltrials.gov]

  Background Pes cavus and Pes Planus are two foot deformities and could be detected through baropodometrical digital techniques. [academic.oup.com]

  Foot Deformity Differences in Diabetic Patients with Pes Cavus and Pes Planus The purpose of this analysis w The purpose of this analysis was to describe associations for foot deformities among normal feet, pes planus or pes cavus. [professional.diabetes.org]

  Despite being a very common foot deformity, flatfoot is one of the least understood orthopaedic problems, and the opinions regarding its optimal treatment vary widely. [ncbi.nlm.nih.gov]

• Fracture

  We present the case of a 14-year-old female who presented with unilateral pes planus 30 months after a bimalleolar ankle fracture dislocation. [ncbi.nlm.nih.gov]

  This can result in medial tibial stress syndrome: shin splints or tibia stress fractures. [physioworks.com.au]

  Adult acquired flat foot may occur due to any of the following causes: Posterior tibial tendon insufficiency (the most common cause) Tearing of foot ligaments Diabetes Poliomyelitis Fractures Loose ligaments Abnormal bone unions in the hind foot Degenerative [docpods.com]

• Medial Tibial Stress Syndrome

  This can result in medial tibial stress syndrome : shin splints or tibia stress fractures. [physioworks.com.au]

  Medial Tibial Stress Syndrome or "Shin Splints" Due to the excessive pronation can cause the tibialis posterior or soleus muscle to apply altered stress to the inside aspect of the tibia. This can result in medial tibial stress. [boyner-clinic.com]

• Decrease in Height

  Decreased calcaneal pitch: normal pitch is between 17-32 degrees, anything less than this is a result of decreased arch height (figure 5b). Decreased cuneiform floor height is also indicative of loss of arch height (normal distance is 15 to 25mm). [opnews.com]

• Irritability

  Fecal transplant is used to treat gut infections and is now being studied as a treatment for obesity, urinary tract infections, irritable bowel syndrome and more. [nytimes.com]

  To further enhance the cushioning, padded collar and tongue as well as soft fabric lining is included to make sure you have an irritation-free experience even with wearing socks. [bestfashionnova.com]

  Ulcers form due to factors such as lack of feeling, foot deformities, irritation, trauma, and poor circulation (peripheral vascular disease). Symptoms Many people who develop foot ulcers have lost the ability to feel pain, so pain is uncommon. [physiciansfootcare.com]

   Thin or thick bar composed of bone (synostosis), cartilage (synchondrosis) or fibrous tissue (syndesmosis) connects tarsal bones  Failure of embryonic segmentation  Calcaneum is held in eversion  An irritative focus is produced which causes painful [de.slideshare.net]

• Confusion

  I'm confuse about the definition between pes planus and pes planovalgus. Are they synonymous? I have read from article that pes planovalgus is pes planus with heel valgus. [podiatryarena.com]

  The term pes planus is a physical finding that generates some confusion in the medical community because it describes a spectrum of conditions that are diagnosed and managed differently. [ncbi.nlm.nih.gov]

  Admission Transfer Credit Evaluator Admission Transfer Credit Evaluator Transferring can be a confusing process. Pace's Transfer Credit Evaluator makes it easier—see whether your credits may transfer and what steps you need to take. [pace.edu]

  […] paediatric flat foot proforma is an instrument for assessing for pes planus in mid-childhood, although as yet there is no clear and evidence-based treatment algorithm. [ 15 ] However, overall there is no standardised evaluative framework and the condition is confused [patient.info]

• Unstable Gait

  Scoliosis, the abnormal curvature of the spine, can cause an uneven and unstable gait, leading to unilateral (one-sided) flat-footedness. Shoes can also contribute. [verywellhealth.com]

Diagnosis of pes planus is made by a preliminary physical examination of the foot. The formation of arch upon standing on the toes will determine the type of flat foot present. For example, if an arch is formed when the individual stands on the toes then the condition is known as flexible foot. However, when no such arch in formed then the condition is referred to as rigid flat foot.
Individuals with flexible foot require no further tests or treatment. But, those diagnosed with rigid flat feet have to undergo the following diagnostic procedures:

• Plain X-ray and weight bearing X-ray of the affected foot to further understand the condition [8]. 
• Imaging studies such as CT scan of the bones and MRI of the tendons of the foot are also required to occur at definite diagnosis.

Children and toddlers affected by pes planus do not actually require any treatment if they are not experiencing any pain or discomfort while walking and even otherwise [9]. However, when the condition causes pain then the following methods are available:

• A foot support known as orthotic is inserted into the shoes that provides support to the feet. In certain cases, doctors also recommend special shoes with heels to be tailor made that need to be worn until the arch forms naturally.
• Certain lifestyle changes such as regular exercise to lose weight may be recommended. Affected individuals are advised to avoid standing or walking for longer durations.
• Medications may be prescribed to relieve the pain and discomfort.
• Surgical intervention is usually the last resort and is employed only when other treatment methods are not effective enough or the condition is causing great discomfort to the individual [10]. This involves, creating an arch in the foot, fusion of the bones, and repairing the tendons.

Majority of the cases of pes planus do not need any treatment as individuals do not experience any symptoms. In conditions when they experience pain, several treatment methods are employed to relieve pain and discomfort. Some cases of flat foot may require surgical intervention to correct the problem. Individuals benefit from the method and the prognosis is usually favorable. Pes planus from tendon rupture may require prompt surgical intervention, delay in the intervention may result into a poor prognostic outcome [6].

Complications

Pes planus by itself can rarely cause any serious complications. However, when the condition requires surgery then post-surgical complications include the following:

• Infection 
• The bones that were fused do not heal
• Pain persists even after the procedure
• Foot deformity does not get corrected
• Loss of ankle movement

Pes planus results when the tendons in the foot are loose. It is a common condition for infants and toddlers as the tendons take some time to tighten and form an arch. Other causative factors that give rise to pes planus include the following:

• Heredity 
• Illnesses or injury to the legs that damage the tendons
• Diseases such as muscular dystrophy and cerebral palsy can also give rise to pes planus
• Posterior tibial tendon insufficiency [1]
• Obesity [2]
• Traumatic rupture of foot ligaments [3]
• Other disease conditions such as rheumatoid arthritis and diabetes can cause the arch to flatten in individuals who otherwise did not have pes planus

Pes planus is a common condition affecting about 25% of the American population. In majority of the cases, the condition is reversible and can get corrected if treatment is initiated at right time. Acquired pes planus is fairly common in middle-aged women who are obese [4].

Under normal circumstances, the tendons of the foot develop in a way to form an arch. In condition of pes planus, the tendons do not form a longitudinal arch. However, if such a condition occurs normally then it gets corrected by itself as the child grows up. The tendons tighten and gradually form an arch. In some cases, it takes several years for the arch to develop and in some the arch does not develop at all. There are basically 3 types of pes planus namely: Flexible flat foot, short Achilles tendon and posterior tibial tendon dysfunction with interosseous ligament involvement [5].

Pes planus cannot be prevented since it is more of a heredity condition. However, the onset of secondary complications can be prevented by appropriately following the treatment recommended by a podiatrist.

Pes planus, commonly referred to as flat foot, is a condition wherein the foot does not form the normal arch in the standing position. It a common condition affecting millions of individuals across the globe. Such a kind of condition is normally identified in infants and toddlers.

Pes planus can get corrected by the time the child is 3 years old. Flat foot may be present in one or both the feet. There are no associated symptoms and pes planus can seldom lead to any serious consequences.

Definition

Pes planus also known as flat foot is a condition characterized by absence of an arch in the foot in the standing position. This condition is a normal phenomenon in infants and toddlers and usually gets corrected as the child grows. With growing age, the tendons tighten and gradually form an arch. It has been estimated that about 20 – 25% of the population fall prey to such a condition. Pes planus seldom gives rise to serious secondary conditions.

Cause

Heredity is one of the common causes of pes planus. In addition, other conditions such as diseases and injury to the feet are also known to give rise to flat foot.

Symptoms

In majority of the cases, flat foot has no accompanying signs or symptoms. But, certain types of pes planus such as rigid flat feet may cause pain and discomfort while walking.

Diagnosis

Affected individuals are made to stand on their toes and the examination is carried out. If an arch is formed in this position, it implies that the individual is suffering from flexible flat foot. Such a condition does not require any further diagnosis. If no arch is formed then further tests such as CT scan, MRI and X-ray of the feet is carried out for differential diagnosis.

Treatment

Individuals are given foot support to be worn inside the shoes that provide support to the foot while walking. Medications may also be prescribed if there is pain and inflammation. Surgery is employed to fuse the bones together or lengthen the tendons if they are too short to form an arch.

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2. Funk DA, Cass JR, Johnson KA. Acquired adult flat foot secondary to posterior tibial-tendon pathology. J Bone Joint Surg Am. Jan 1986; 68(1):95-102.
3. Levy JC, Mizel MS, and Wilson LS, et al. Incidence of foot and ankle injuries in West Point cadets with pes planus compared to the general cadet population. Foot Ankle Int. Dec 2006; 27(12):1060-4.
4. Myerson M, ed. Posterior tibial tendon insufficiency. Current Therapy in Foot and Ankle Surgery. St Louis, Mo: Mosby-Year Book; 1993:123-35.
5. Campbell KJ, Michalski MP, Wilson KJ, Goldsmith MT, Wijdicks CA, LaPrade RF. The ligament anatomy of the deltoid complex of the ankle: a qualitative and quantitative anatomical study. J Bone Joint Surg Am. Apr 16 2014; 96(8):e62.
6. Goldner JL, Keats PK, Bassett FH 3rd, Clippinger FW. Progressive talipes equinovalgus due to trauma or degeneration of the posterior tibial tendon and medial plantar ligaments. Orthop Clin North Am. Jan 1974; 5(1):39-51.
7. Pinney SJ, Lin SS. Current concept review: acquired adult flatfoot deformity. Foot Ankle Int. Jan 2006; 27(1):66-75.
8. Kong A, Van Der Vliet A. Imaging of tibialis posterior dysfunction. Br J Radiol. Oct 2008; 81(970):826-36.
9. Rome K, Ashford RL, Evans A. Non-surgical interventions for paediatric pes planus. Cochrane Database Syst Rev. Jul 7 2010; CD006311.
10. Key JA. Partial rupture of the tendon of the posterior tibial muscle. J Bone Joint Surg Am. Oct 1953; 35-A (4):1006-8.