Coping with Flat Feet

What are Flat Feet?

People may experience musculoskeletal issues as a result of how their feet are shaped, whether their issues come genetically or through some repetitive stress throughout their lives. Chiropractic care can be of great assistance to those who are bothered by flat feet. Flat feet, or “fallen arches”, occur when the foot arch collapses. This means that the foot’s sole has come completely in contact with the ground. In up to 1/3 of people, the arch never even develops to reach a proper height. 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 has not yet occurred, so it is not usually a major concern when the condition is seen in infants.

Training the Feet to Prevent Flat Feet

Feet can actually be trained, as a result of performing certain exercises regularly 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. It is very often important that parents intervene during their child’s foot development and long after to make sure that the child learns proper posture when walking to avoid future difficulties later in their lives. Flat feet have been shown to be less common in those who have grown up walking barefoot regularly versus those who wore shoes more often during development.

Flat Feet in Adults

Adults can acquire flat feet as a result of “faulty biomechanics”, foot stress, injury, or illness. The increased 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, as many aspects of the body’s major development have slowed or stopped at a certain age. That’s why, adults have to remember how to maintain proper and posture and gait as well.

There are people who have what is called a “flexible flatfoot”. These individuals have flat feet when standing at their full height 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. Nonetheless, muscles training may prevent the from drastically leveling out. 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 during the simple test, 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.²

Excessive Pronation

Chiropractors 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 that the patient has been regularly using over a very long period of time 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.

Orthotic Devices

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”. Every patient is different, so it is not uncommon for patients to have to get custom orthotics rather than just walking into a store and easily finding the right shape for them.⁴ Pain and misalignment caused by compensation for flat feet will often cause further problems in the rest of the body, which could then, in turn, worsen the patient’s overall condition. Regular chiropractic treatment can help those with musculoskeletal issues and pain as a result of their having flat feet.