3 Follow-up evaluations have determined that 90 percent of these children will have normal arches by the age of 10 years. As adults, some of those who develop a normal arch gradually lose it. This occurs secondary to a breakdown of the normally strong and dense connective tissues of the foot. 6 Normal alignment depends on a complex arrangement of dense collagenous fibers, and no single structure provides all of the support. 7 Problems with this arch will develop when these supportive tissues are put under excessive stress.
Differentiation is important, but can be easily done during the examination.
If the foot remains flat and rigid during this test, any attempt to lift up or support the arch can be painful, and corrective orthotics generally are avoided. Evaluation by a foot specialist is usually necessary to determine the underlying cause of a rigid flatfoot. Two descriptive terms are often used interchangeably with flatfoot, and can contribute to confusion. Both of these problems are found in patients with flexible flatfoot, and will interfere with lower extremity biomechanics. The participants were 18-38 years old, and had no specific foot symptoms.