Most people have a natural arch to their feet. The definition of flat feet is a condition where the arch is not present and the entire soles of the feet touch the ground. An old term for flat feet is fallen arches. Having flat feet does not always cause pain or lead to other foot disorders.

Many people with flat feet experience no symptoms. If your bare foot flattens out when you stand on it and it is not painful, treatment is not needed. Most people with flat feet will notice their arch will return with toe walking. You should however, wear good fitting, supportive shoes. Children under the age of five normally have flat feet.

Flat feet that are rigid, not flexible, can be painful and result in imbalances from prolonged foot and leg discomfort. They may even cause back pain. Rigid flat feet are linked with inactivity and increased body weight. Shoes that do not fit or fail to support and protect the arch can lead to painful imbalances between the bones, muscles and ligaments of the foot.

People who have rigid arches may have pain when they stand or walk. This problem, if not corrected, can lead to other foot problems, such as:

• an inflammation of the soft tissue under the skin on the bottom of the feet or

• bone spur, an outgrowth of bone on the heel in response to constant irritation

If a child's foot does not develop an arch by age five, have the child's feet evaluated by the child's healthcare provider at the next checkup.

Causes, incidence, and risk factors

Flat feet are a common condition. In infants and toddlers, the longitudinal arch is not developed and flat feet are normal. The arch develops in childhood, and by adulthood, most people have developed normal arches.

Painful flat feet in children are often caused by a condition called tarsal coalition. In tarsal coalition, two or more of the bones in the foot fuse together limiting motion and often leading to a flat foot.

Most flat feet do not cause pain or other problems. Flat feet may be associated with pronation, a leaning inward of the ankle bones toward the center line. Shoes of children who pronate, when placed side by side, will lean towards each other (after they have been worn long enough for the foot position to remodel their shape).

Daily practice of Virasana, which stretches the top of the foot and strengthens the arches, is necessary. Virasana for 10 minutes each day before bedtime. During the practice of this wonderful pose, massage the arches of your feet, pressing on the arches as if cultivating an arch with your thumbs. While practicing standing poses, carefully press the big toe mounds and inner heels down into the floor, and powerfully recoil the arches up into the inner ankles. This may be difficult initially, but will eventually build the strength that you need in your arches.

Standing poses would help, particularly Uttkatasana with toes lifted off the floor. You could suggest a whole series starting with Tadasana with toes off the floor, then Uttkatasana, then one-legged poses like Vrksasana and Ardha Chandrasana initially and then Virabhadrasana 3, Garudasana, Natarajasana. Some others would be squatting poses like Malasana (just squatting without the hands and the head in the equation) and Pasasana. Actually coming to think of it the first stage of Bakasana (Crane pose) is squatting. Another one would be Bhekasana (Frog pose) even though it is done by lying on one's stomach; the bending of the arches

VIRASANA

Vira means a hero, warrior, champion. This sitting posture is done by keeping the knees together, spreading the feet and resting them by the side of the hips. The pose is good for meditation and pranayama.

Technique

1. Kneel on the floor. Keep the knees together and spread the feet about 18 inches apart.

2. Rest the buttocks on the floor, but not the body on the feet. The feet are kept by the side of the thighs, the inner side of each calf touching the outer side of its respective thigh. Keep the toes pointing back and touching the floor. Keep the wrists on the knees, palms facing up, and join the tips of the thumbs and forefingers. Keep the other fingers extended. Stretch the back erect.

3. Stay in this position as long as you can, with deep breathing. Then rest the palms on the knees for a while.

4. Then rest the palms on the knees for a while.

5. Now interlock the fingers and stretch the arm straight over the head, palms up.

6. Stay in this position for a minute with deep breathing.

7. Exhale, release the finger lock, place the palms on the soles, bend forward and rest the chin on the knees.

8. Stay in this position for a minute with normal breathing.

9. Inhale, raise the trunk up, bring the feet forward and relax.

10. If you find it difficult to perform the pose as described above, try placing the feet one above the other and rest the buttocks on them. Gradually move the toes further apart, separate the feet and bring them to rest outside the thighs. Then, in time the buttocks will rest properly on the floor and the body will not rest on the feet.

Effect

The pose cures rheumatic pains in the knees and gout, and is also good for flat feet. Due to the stretching of the ankles and the feet, proper arches will be formed. This, however, takes along time and requires daily practice of the pose for several months. Those suffering from pain in the heels or growth of calcaneal spurs there will get relief and the spurs will gradually disappears. The pose can even be done immediately after food and will relieve heaviness in the stomach. 

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