Flat feet: where does it come from and whether it needs to be treated

By | August 17, 2021

FLAT FEET IS A PHENOMENON KINDLY KNOWN TO EVERYONEbut surrounded by conflicting opinions. On the one hand, it is believed that the foot simply cannot be ideal for a person who lives in the city and wears shoes, and everyone has flat feet to one degree or another. On the other hand, we are often convinced that without individual orthopedic insoles, over time , not only the legs, but the spine will suffer, and the posture will irreversibly deteriorate. We tried to figure out how the foot is arranged, when it needs special care and what shoes are best not to wear.

What is this anyway?

When on the inside of the foot there is no arch gently curved inward – the so-called arch of the foot – this condition is called flat feet. If the arch of the foot is present only at the moment when the person is standing, but disappears when the leg is raised, this type of flat feet is called mobile. If the shape of the foot does not change when the leg is in weight, this is a rigid, or stiff, flatfoot.

Mobile flat feet are considered normal in young children – they are not born with a normal arch. In newborns, the foot is, as it were, curved outward – there is a fatty lump that dissolves over time; it is needed in order to soften the load. In some cases, the formation of the arch of the foot is completed by the age of seven to ten, but this usually happens earlier. In adults, mobile flat feet is observed in 15–25% of cases – and most often does not cause any concern. In many adults with mobile flat feet, this condition is hereditary, and these people usually have extremely flexible and highly mobile joints. Flat feet can also develop in adulthood due to joint diseases such as rheumatoid arthritis.

Rigid flat feet , unlike mobile ones, are often the result of a more serious problem affecting the structure or position of the bones that make up the arch of the foot. For example, it can occur due to a rare congenital situation in which the bones of the foot are not properly aligned, or a condition where several bones have fused together, which significantly impairs flexibility. These are rare hereditary conditions that often occur in several generations of the same family. With an initially normal arch of the foot, acquired flat feet can develop as a result of trauma – for example, dislocation of the talus. This usually occurs due to injury from a fall from a height, car accident, or sports injury.

Can shoes provoke or prevent flat feet?

The arch of the foot is a genetically programmed element of anatomy. Initially, our foot is designed for walking barefoot – that is, nature does not know what a shoe, an instep support, an orthopedic insole are. In Soviet pediatrics, it was believed that if you set a certain outline for the development of the foot in the form of an instep support and a hard back, then the child’s leg would develop according to the given parameters – and, unfortunately, many doctors still adhere to such recommendations, forcing parents to buy hard shoes for their children. from the very first steps. Nevertheless, the shape of the arch of the foot is genetically inherent, it is impossible to change it with instep supports, and there is not a single study that would confirm the opposite.

The instep support is needed in shoes for the simplest reason: it is much more convenient to wear shoes that follow the anatomical shape of the leg. For example, sports shoes always have an instep support – it is needed so that the athlete’s feet are comfortable and stable, but the instep support in running shoes does not exactly form the runner’s arch. Shoes with a suitable instep support and precisely matched in size are a matter of convenience and prevention of other problems, such as ingrown nails or the appearance of calluses.

Shoes with high heels do not deform the bones of the foot (if, of course, the correct size is selected), but greatly increases the tension of many small muscles. For those who wear heels for more than forty hours a week, the muscle performance when walking is impaired and their fatigue builds up. Normally, nerve endings constantly determine the position of our muscles in space and relative to each other – this is called muscle sense, or proprioception. At the slightest imbalance, the brain instantly receives information about this and directs the impulse to align the position. When walking in heels for a long time, tired muscles can signal that the balance is disturbed, with a slight delay, and the nervous system will not have time to react in time – so that the risk of falling or injury increases even when walking on a smooth floor.

Why can the leg enlarge during pregnancy?

It is often said that during pregnancy the leg “grows” by size – in fact, of course, we are not talking about growth, but about deformation due to a rapid increase in body weight. In 2014, a study was conducted with the participation of 49 pregnant women; the size of the arch of the foot was measured in different states (at rest and in motion), first in the first trimester of pregnancy and then 19 weeks after delivery. During pregnancy, the height and rigidity of the arch of the foot decreased significantly, and this was accompanied by lengthening of the foot – thereby increasing the size of the shoe. During the first pregnancy, the changes were more significant.

Another study , conducted in Russia, examined changes in the feet after cyclic physical activity in runners. One hundred twenty athletes performed a special exercise – a long run on an incline. As a result, there was a significant decrease in the height of the arch of the foot. It is interesting that in men this reduction of the fornix was transverse, and in women it was longitudinal. In this case, the arising flat feet were of two types: compensated (or dynamic) and true. With compensated flat feet after a special period of rehabilitation, the parameters of the foot returned to their initial values, but with true flat feet, the arches of the feet remained reduced.

As for the relationship between the shape of the foot and posture – when examining 58 seven-year-old children, it was found that flat feet in itself do not affect posture. But it is affected by excessive pronation (collapse of the foot); requires attention and correction to avoid subsequent problems. This also happens in adults – scientists have found that women with excessive pronation of the foot have a higher risk of pain in the lower back than those who put their feet in a neutral position.

When do you still need to see a doctor?

Correction and treatment are needed only in cases when there is discomfort associated with flat feet – pain or, for example, excessive pronation of the foot (a condition when the foot “falls too much” inward or outward when walking). Non-surgical treatment is recommended first, although surgery may be required in some cases. The doctor may recommend wearing comfortable shoes that support the leg well, use special insoles that support the feet and prevent them from falling over, take pain relievers for discomfort, normalize body weight if it is excessive, and stretch the leg muscles.

It should be understood that these procedures will not change the shape of the feet, but can help reduce some of the problems associated with flat feet. If these measures do not help, the next step is to contact an orthopedic surgeon for advice about a possible surgery. It is impossible to prevent flat feet – it is a hereditary phenomenon. All you can do is wear comfortable shoes to keep your feet comfortable and not put stress on your feet yet.

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