Flat Feet & Orthotics

There is always a lot of discussion around flat feet and orthotics in the world of podiatry, one of the most commonly asked questions we as podiatrists get asked is “I think I have flat feet; do I need orthotics?”. Like many topics in healthcare there is no right and wrong answer for every individual, some people may benefit from orthotics while other people may be active and move through life without ever needing orthotics. In this blog we’ll breakdown some of the key points to give you a greater understanding of the topic. 

What are Flat Feet? 

Pes planus or “Flat Feet” as the name most people know them by, is typically defined by the presence of a lower or flatter medial arch within the inside of one’s feet. Typically, it is considered either flexible or the far less common rigid variety with estimates putting the prevalence of flexible flat feet between 2-23% of adults while the rigid variety sits at no more than 1% of adults. Both feet can be affected or sometimes one foot may be flatter than the other.

There are many anatomical features which impact the height of your arch including:

  • Bones from your heel, midfoot and right through to your toes
  • A number of muscles on both sides of your feet, such as tibialis posterior and anterior, peroneus longus, flexor hallucis longus and intrinsic foot muscles
  • There are also many ligaments which aid the bones and muscles in maintaining arch posture

There is no one single reason why one person may have a lower arch compared to someone else, it is usually a combination of factors including:

  • Genetics and ethnicity 
  • Ligaments which have become loosened 
  • Mobile joints
  • Musculoskeletal conditions such as posterior tibial tendon dysfunction, a common condition which stops a key muscle on the inside of your foot and leg from holding your arch up 

Should I be worried about my flat feet?

In short, not necessarily. You may have noticed the arches of your feet aren’t the same height as your family or friends and that’s okay. Everyone will have arches of varying heights and having a flatter foot doesn’t mean you have bad feet. 

Although, if you do have flat feet and start to experience pain in your feet, knees, hips or back it is certainly worthwhile being assessed to establish whether your foot posture is playing a role in your pain. 

If you notice a change in your arch height after an injury it is highly recommended that you see your health care provider to ensure nothing sinister is at play. One of the key clinical signs of posterior tibial tendon dysfunction, a potentially debilitating condition, is a lowering of the arch and it is best caught early while it is relatively easy to correct. 

How can orthotics help flat feet?

Essentially an orthotic device is designed to alter biomechanical load patterns or more simply alter the stress certain muscles and joints are put under. Orthotics take this undue stress from particular bones or muscles and spread that load across a greater area, therefore reducing the overall load an injured area of the lower limb has to withstand.

For people with flat feet, struggling with issues through their feet, knees, hips and back, orthotics can be effective at guiding the lower limb into its most biomechanically efficient position taking excessive force away from an injured area and giving them the ideal environment for healing. The orthotic is typically not designed to give you a higher arch as such but rather to accommodate your flat foot ensuring it is not taking too much of the stress generated through each step during your day.

Orthotic technology is always evolving and in clinic we use the latest 3D scanning techniques to ensure a fully customised fit to maximize your comfort and the devices function. Orthotics can be designed in a large variety of shapes, sizes and features so no matter whether they are needed for athletic, work or casual footwear there will always be an orthotic suitable for you.

To summarise the key points above:

  • Flat feet happen for a variety of reasons, many of which are not under our control.
  • Having flat feet isn’t necessarily a concern unless you develop any symptoms or feel like they may be contributing ongoing concerns through feet, knees, hips and back.
  • Orthotics can offer relief for a variety of conditions related to flat feet.
  • Orthotics have come a long way from the old rigid bulky designs of the past to much lighter, more flexible and comfortable devices.
  • If you are unsure whether flat feet are an issue for you, best to book in for an assessment with one of our friendly podiatrists.   
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