Flat feet or fallen arches can make walking, standing, and exercising uncomfortable. It’s an interesting term that doesn’t always sit well with Podiatrists. The difficulty with it is trying to determine what is considered ‘normal’ and what could be a problem. If your feet appear to have no arch and excessively roll inwards and downwards towards the floor when you’re standing, then they are likely flat feet.

Often, even though your feet may appear to have a well-defined arch when you sit and have your foot off the ground, feet will become much flatter when you stand on them. We are most interested in this ‘weight-bearing’ position when you’re standing. This inwards rolling, known as pronation, can place excess stress on muscles, tendons, ligaments and bones in the feet, making you more vulnerable to foot pain and injury.

This article shares tips on what an appointment will look like if you suffer from flat feet, choosing comfortable shoes, additional support options, and lifestyle adjustments to help manage flat feet.

Understanding Flat Feet?

Flat feet, also known as “fallen arches,” are a condition where the arches are either low or absent, causing the entire sole to make complete contact with the ground when standing. In a typical foot, the arch creates a natural curve in the middle of the foot, which helps distribute weight evenly and provides shock absorption. However, this arch is wholly or partially collapsed in people with flat feet. This condition can lead to pain in the feet, knees, hips, and lower back. Fortunately, with the proper support, individuals with flat feet can live comfortably and reduce strain on their bodies.

What causes flat feet?

Most feet have an upward curve on the inside, between the heel and the ball of the foot. This is called the arch.  Tendons running from the heel to the end of the foot bones, along with tendons in the lower leg, work together to form the arch.  When the tendons have the proper amount of tension, your foot has a normal arch. When they don’t, you have little or no arch, which is called flat foot or fallen arches.

There are many causes of increased pronation that give rise to the appearance of flat feet. The most common being:

The most common being:

• Hereditary or genetic predisposition.
• Abnormal muscle length or muscle tone. (e.g. tight calf muscles can cause pronation as a compensatory mechanism)
• Abnormal leg rotations. (e.g. bow legs or knock knees can be functional or structural altering forces through the feet)
• Hypermobility or ligamentous laxity
• Poor pelvic or hip alignment or alignment causing leg length differences
• Spinal conditions (e.g. scoliosis)

What are the steps for getting diagnosed with flat feet?

Diagnosing flat feet or fallen arches involves a combination of physical examinations, imaging tests, and assessments to understand the extent and cause of the condition. Here’s a step-by-step overview of the process:

Book a biomechanical assessment with one of our qualified podiatrists, the first step in the right direction. During this one-hour appointment, we will discuss your history and complete an intensive assessment of your lower limbs.

This may include:

• Visual Inspection: The Podiatrist will observe your feet while standing, walking, and possibly sitting. This helps to see how your feet flatten when bearing weight.
• Arch Height Test: You may be asked to perform a heel raise or stand on your tiptoes. If an arch appears during this movement, it’s an indicator of flexible, flat feet. If the arch remains absent, this may suggest a more rigid form of flat feet.
• Alignment Check: The Podiatrist may check the alignment of your knees, hips, and spine to see if flat feet are causing overpronation (excessive inward rolling of the feet) and contributing to other alignment issues.
• Gait Analysis: The Podiatrist may have you walk to assess your gait (the way you walk). This helps determine if your flat feet are causing overpronation or other gait abnormalities. They will also pressure map your feet. Pressure-sensitive mats are used to analyse how weight is distributed across the foot as you walk. This detailed analysis can show where the most strain is placed on your foot and how flat feet may affect your movement.

2. During the assessment, the Podiatrist will assess the range of motion in your feet and legs and check the muscles in your feet and legs for any strength or flexibility concerns. We will also complete a gait analysis, monitoring your lower back, knees, ankles, and feet while you walk. Other factors, such as exercise levels and current footwear, will also be discussed.
3. If you require further investigation, the Podiatrist can refer you for additional testing like:

• X-rays: An X-ray may be taken to examine the alignment of bones in the foot and detect any structural abnormalities or damage from arthritis.
• MRI (Magnetic Resonance Imaging): If a tendon issue, such as posterior tibial tendon dysfunction, is suspected, an MRI can provide a detailed image of soft tissues and assess any damage or inflammation.
• Ultrasound: An ultrasound may be used if there’s suspicion of a tendon or ligament injury contributing to flat feet. It helps evaluate soft tissue damage and can detect inflammation.
• Diagnosis and Treatment Planning: After reviewing your symptoms, gait analysis, and imaging results, the doctor will diagnose you and recommend a treatment plan. This plan could include exercises, custom orthotics, supportive footwear, or further intervention if needed.

Living with Flat Feet: Tips for Comfortable Shoes and Everyday Support

Choose the Right Shoes

Selecting the right shoes is crucial for managing flat feet. Here’s what to look for:

• Arch Support: Find shoes with built-in arch support to help lift the foot and reduce pressure.
• Firm Heel Counter: A sturdy heel counter provides stability, preventing excessive foot movement.
• Shock Absorption: Shoes with cushioned soles help absorb impact, reducing strain on the feet and legs.
• Roomy Toe Box: A wider toe box allows toes to spread naturally, reducing discomfort.

The team at East Gosford Podiatry can recommend brands and stores that specialise in supportive footwear to provide relief from flat feet.

Consider Custom Orthotics

Custom orthotics can be a game-changer for those with flat feet. These inserts, designed by podiatrists, provide targeted arch support and help realign the foot structure. East Gosford residents can consult local podiatrists to get a fitting for custom orthotics. The benefit of custom orthotics over store-bought insoles is that they’re tailored to your unique foot shape, ensuring maximum comfort and support.

Incorporate Foot-Strengthening Exercises

Regular exercises can improve foot strength and flexibility, which is beneficial for managing flat feet. A few exercises to try include:

• Toe Curls: Spread a towel on the floor and use your toes to grip and lift it.
• Heel Raises: Stand with feet flat and rise onto your toes, holding the position for a few seconds before lowering.
• Arch Lifts: While sitting, press your big toe into the ground while lifting the arch.

Adding these exercises to your routine can strengthen the foot’s intrinsic muscles, providing natural support.

 Maintain a Healthy Weight

Excess weight places extra pressure on the feet, worsening flat feet symptoms. Maintaining a healthy weight helps alleviate some of this strain, making it easier to manage pain. Consider incorporating low-impact exercises like swimming or cycling to stay active without putting too much pressure on your feet.

Regularly Consult an East Gosford Podiatrist

Routine check-ups with a podiatrist can significantly improve the management of flat feet. East Gosford podiatrists offer professional guidance, custom orthotic fittings, and tailored treatment plans. Consulting with a specialist will give you personalised advice and treatment for your specific needs, ensuring you live comfortably and avoid long-term complications.