Coping With Flat Feet

People may experience musculoskeletal issues as a result of how their feet are shaped. Chiropractic care can be of great assistance to those bothered by flat feet.

What are Flat Feet?

Flat feet, or “fallen arches”, occur when the foot arch collapses. This makes the foot’s sole completely contact the ground. In up to 1/3 of people, the arch never even develops. This can happen to one or both feet. Babies may appear to have flat feet due to “baby fat” and the fact that arch development hasn’t yet occurred. Feet can actually be trained, as a result of certain exercises and walking barefoot, to develop the arches. Typically, the arch is established by 6 years of age. Parents can assist children who walk on the “outer edges of the feet, or…limp”. If the children have pain after walking, particularly in the calves, knees, or feet, this can indicate the presence of flat feet. Flat feet have been shown to be less common in those who have grown up barefoot versus those who wore shoes during development. Adults can acquire flat feet as a result of “faulty biomechanics”, foot stress, injury, or illness. The risk factors for this are obesity, diabetes, hypertension, being a woman over 40, or pregnancy. Those who develop flat feet as an adult will likely have this condition permanently. There are people who have what is called a “flexible flatfoot”. These individuals have flat feet when standing, but have an arch when they “dorsiflex” (pull just the toes back or stand on heels). In this case, the Windlass mechanism is functional and the medial longitudinal arch is still there. Muscle training can be helpful, but arch height will not increase. Foot muscles are short and no longer grow in adults.¹

Diagnosis and Treatment

The flat foot is diagnosed visually and with the “wet footprint” test. The more of the sole that appears, the flatter the person’s foot is. Flexible flat feet usually have no symptoms; these days, if there is no pain, the military will no longer automatically turn down those with flat feet. People with “rigid flatfoot”, when the foot remains flat even when not standing, may experience pain due to the bone problems present in the feet. Arthritic patients may need more help than wearing orthotics: “ankle fusion” may be a medical solution. Traditional treatments will include orthotics for those who have lower leg, back, and knee pain. Foot gymnastics and exercises may be recommended. Orthoses that have more material added to them over time can help to raise the arch in some patients. Patients may wear these for the rest of their lives.²Chiropractors may look for “excessive pronation” (foot rolling inward) in patients complaining of shin splints and other leg and foot problems. In the “Achilles Tendon Test”, for example, pronation will be obvious because instead of the Achilles tendon running straight down, it will twist at the heel, jutting out the inner ankle bone. In the “Used Shoes Test”, the shoes are viewed at eye level; if they tilt inwards, or if there are “wear marks along the outer edge of the heel and inner edge of the toe areas”, this indicates excessive pronation. Chiropractors will often recommend orthotic devices.³ It is very important that the orthoses fit the patient well and have the proper materials: “support is needed for all three arches of the foot, along with cushioning and shock absorption”.⁴ Regular chiropractic treatment can help those with musculoskeletal issues and pain as a result of having flat feet.