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You probably don't give much thought to the steps you take. However, walking is actually quite a complex act, especially for your feet. Because your feet support all of your weight and help you balance when you stand, they're subject to substantial pressure and risk of injury.

Causes

Your feet are highly specialized structures. Each foot is made up of 26 bones held together by 33 joints and more than 100 muscles, tendons and ligaments. The intricate alignment of these structures results in the formation of your arches.

As you walk, these springy, elastic arches help distribute your body weight across your feet and legs. Your arches also play an integral role in how you walk. They act as rigid levers for proper mobility, but they must also be resilient and flexible to adapt to various surfaces.

Flat feet are normal in infants and toddlers, because the foot's arch hasn't developed yet. Most people's arches develop throughout childhood, but some people never develop arches. This is a normal variation in foot type, and people may or may not have problems without arches. Lax ligaments can cause flatfeet, as can congenital conditions that affect the foot.

Arches can also fall over time. Years of wear and tear can weaken the posterior tibial tendon, which runs along the inside of your ankle, from above your ankle to your arch. The posterior tibial tendon is the main support structure for the arch. An overload to this tendon can cause inflammation of the tendon (tendinitis) and even tearing of the tendon. Once the tendon is damaged the foot's arch loses support and can flatten.

You may lose support in your arches due to:

  • Ongoing stresses in your feet. One of these stresses may be long-term wearing of high heels, which can affect your Achilles tendon and change the mechanics of your ankles. Compensation by the posterior tibial tendon may eventually cause it to break down and your arches to fall.

  • Obesity

  • Traumatic injury to your foot or ankle.

  • Rheumatoid arthritis.

  • Diabetes.

Flatfeet > 1 > 2 > 3 > 4

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