1. Pes Planus

2. Pes Planus Pes planus is a condition where the arch or instep of the foot collapses and comes in contact with the ground. In some individuals, this arch never develops.

3. Predisposing Factors • Excessive pronation of the foot Mechanism of injury • Can be a congenital problem • Fracture • Dislocation • Tarsal coalition • Tendon laceration • Arthritis • Neuroarthropathy • Neurological weakness • Iatrogeny • Posterior Tibial Tendon Dysfunction • Most common • Diabetes • Overweight • Excessive exercise • Wearing shoes too tight

4. Presentation • Possible abnormal gait Signs and symptoms • Pain • Calcaneal eversion • Bulging of the navicular bone Evaluation • If this is not congenital, x-rays to rule out mid foot fracture

5. Treatment • NSAIDS • Orthotics if the condition is causing pain • If there is no pain no treatment procedure should be used

6. Bibliography • Arnheim, Daniel. Principle in Athletic Training. 10th ED McGraw Hill. Boston pg 463-464 • Booher, James and Gary A. Thibodeau. Athletic Injury Assessment. McGraw Hill: Boston, 2000. pg 284 • Hunter, John, MD. “Pes Planus Outline” http://gillespy.rad.washington.edu:8080/footalignment/stories/storyReader$122 • Coady, Catherine, MD; Nina Gow, MD; William Stanish, MD “Foot Problems in Middle Aged Patients: Keeping Active People up to Speed” The Physician and Sports MedicineVol 26 No 5, May 1998http://www.physsportsmed.com/issues/1998/05may/stanish.htm • Hockenberry, R. Todd, MD. “Acquired Flatfoot” http://www.emedicine.com/orthoped/topic461.htm