Earlier this week, headlines flashed that the Tamil Nadu government will not hire drivers with flat feet for vacancies in any of the eight state transport corporations. Though surprising to some, it isn’t entirely new in India. The Services Selection Board (SSB), which shoulders the responsibility of selecting candidates for the Indian Armed Forces, has a practice of disqualifying candidates on medical grounds, depending on the severity of pes planus (flat feet).
The news of the Tamil Nadu state government now has stirred conversations around this medical condition — what it means to have flat feet, how it affects one’s body, and whether or not it truly impacts a person’s fitness for certain professions. Dr Kunal Patel, an orthopedic surgeon with Apollo Hospital, Greams road, breaks it down.
What is flat feet, and how common is it?
Flat feet is a condition where a person doesn’t have the medial arch (the inner arch of the foot from the toe to the heel) in their feet. To understand it simply, for a person with flat feet, every time they place their wet foot on the floor, it’ll leave a complete footprint, unlike a person with the medial arch, where there will be a noticeable gap between the upper and lower part of the feet. It is a common condition. Maybe about 10-20% of the population have flat feet.
Is flat feet a condition people are born with, or can it develop later in life?
Everyone is born with flat feet. During early childhood most people develop the medial arch while some don’t. People who don’t develop the arch can either have flexible flat feet or rigid flat feet. Those with flexible flat feet will notice an arch on their feet normally but wouldn’t notice the arch when they walk. Meanwhile, those with rigid flat feet won’t notice any arch at all. However, even those with the medial arch can develop flat feet in adulthood. This can happen due to weakness in the ligaments or tissues around the bones in one’s feet, causing the feet to fall flat whenever one walks.
Does flat feet cause pain or discomfort while performing daily activities? Can flat feet lead to other problems?
In cases of flexible flat feet, people don’t experience any pain or discomfort while performing regular chores. In fact, some of them even play different sports. But eventually, as they grow older, they might develop pain in their toes or ankles. Those with rigid flat feet will develop pain and discomfort, starting from their 30s or 40s. Flat feet can definitely lead to other problems because most people develop arthritis in their knee joints. This is because the knee is affected due to misalignment caused by flat feet and in many cases, the knees strain due to uneven weight distribution. In many cases, uneven weight distribution also causes ankle arthritis or mid-feet arthritis.
How does having flat feet affect a person’s ability to drive or operate heavy vehicles over long periods?
For people with rigid flat feet, their movements might not be very swift while driving vehicles. Especially heavy vehicles. While driving, our heels are usually on the floor. The ankle has to move from the break to the accelerator and back. So here, some people might find it difficult to move their ankle quickly. But these things are based completely on each individual person’s case. We cannot generalise it because in each case, the ankle joint’s mobility can differ.
What are the common treatments or support available for people with flat feet?
People with flexible flat feet should wear shoes that have medial arch support. Such shoes usually have good cushioning and with the right gear they can do everything from running, to playing any sport. Even those with rigid flat feet should wear soft footwear with medial arch support. There are options such as orthotics (moulds with medial arch support that help with alignment). But in extreme cases, invasive procedures like surgeries can be performed to correct the alignment.
Would you like to comment on this move by the state government? Is it right for them to impose this restriction?
From a medical perspective, I think a blanket order to not consider drivers with flat feet in totality may not be right. A medical examination has to be conducted to decide if or not the person has movement related restrictions in their joints.