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Flat or Overpronated Feet
Flat Feet
Flat feet can be a contributing factor in the development of many foot conditions. A foot that “collapses” or “over pronates” can place stress on several parts of the body and lead to injuries in these areas.
Pronation is the word used to describe the movement of the foot when it rolls in. If this movement is too great it begins to overwork several muscles and ligaments. Pronation has been linked to injuries such as shin splints, heel pain, arch pain, ankle pain, knee pain and Achilles soreness.
What are flat feet?
Flat feet is an expression used to describe a foot with a lower than normal arch. This arch known in the medical world as the medial longitudinal arch is the main arch in your foot that runs from your heel to the ball of your foot. The term flat foot is quite subjective as there is no special point where a foot is considered flat or not although there are several categorisation systems podiatrists used to help make this judgement call.
In most cases arch height is determined genetically and some people will be born with a natural tendency to have flatter feet than others. In some cases however the foot collapse later in adulthood this is normally due to the deterioration of the tibialis posterior muscle through overuse and dysfunction this is known often as adult acquired flat foot and is a condition that needs to be addressed as soon as possible.
In general there are 4 types of flat feet we see most commonly in the clinic.
- Adult acquired flat feet: As mentioned are above these are feet that start life of with a normal arch and become flat through adulthood
- Feet that appear to have a normal arch when non weightbearing but collapse when standing.
- Feet that appear to have a normal arch when standing but pronate (roll in) and collapse during walking.
- Feet that non-weightbearing, standing and during walking are flat throughout.
What conditions can flat feet contribute to?
Flat feet don’t necessarily cause the following but research suggests they can be a contributing factor in:
- Plantar fasciitis
- Tibialis Posterior tendonopathies
- Achilles Tendonitis
- Shin splints
- Stress fractures
- Chronic knee pain
- Chronic ankle pain
- Lower back pain
- ITB friction syndrome
- Hallux limitus/Rigidus (1st MPJ pain)
- Retrocalcaneal bursitis
If you are having trouble with any of these it is worth considering flat feet and pronation as a contributing factor.
How are flat feet treated?
The answer to this is dependent on the severity of your flat foot, if you’re experiencing any current pain or injuries and how your foot is compensating for its flatness and pronation. A treatment plan will address all of these things and may be made of a combination of
Taping
Taping can be used to support and brace the foot and change the foots positioning. This can be done either as a precursor to orthotic therapy or as a treatment in its own right.
Orthotics
Orthotics can be used to help support the foot and make the life easier of certain muscles, ligaments and tendons by reducing their workload. They also offer a long term solution that requires minimal effort on the patient’s behalf.
Footwear
In a number of cases flat feet can be addressed by wearing the right kinds of shoes. We can provide help on what shoes to look for and where to get them from.
K-laser
K-Laser can be used if your flat feet are causing you to experience pain. This can be done as part of a greater treatment plan that will be aimed to eleminate your symptoms, rebuild strength and return you back to the things you want to be doing.
Shockwave
Shockwave treatment can be performed independently or alongside K-Laser therapy. This will be used if your flat feet have created an injury. Shockwave works by stimulating new healing and triggering the healing response.
Dry needling
Dry needling involves using acupuncture needles into trigger points to create a “twitch” response that allows the muscle to elongate and return to its normal length. This lengthening means that muscle tightness and tension is reduced.
Prolotherapy
Prolotherapy is an injection based therapy that can be used at sites of pain by putting small amounts of glucose and local anesthetic at the site of a pain to stimulate healing. This is not specifically a treatment for flat feet but can be used to manage some of the conditions associated with flat feet
Custom rehabilitation program
Custom rehab programs can be used mainly for two purposes with flat feet.
1. Preventatively
This involves identifying the muscle that will be made to work harder as a result of flat feet and prescribing exercises that target those muscles and make them stronger. The stronger we can make a particular muscle the more likely it is to keep up with the extra workload and the less likely it is to get injured. This is a great way to get out in front of a problem and minimise future problems.
2. To help recover from and injury
If your flat feet have contributed to a muscle injury contributed there’s a good chance those muscles are coping with there workload. By building the strength of those muscles back up at deliberate pace we can make them strong enough to cope with the volume of work flat feet ask of them.
We use a free exercise prescription app called physioapp to do this you can learn more about this here.
Surgery
This is very very rarely required to treat and manage flat feet but occasionally in extreme cases surgery can be necessary. We can help point you towards some of the best surgeons in the country if this is the case.
As mentioned after a careful assessment of your flat feet you may not need any therapy. If we feel you do need treatment how your flat feet are managed will depend on a number of factors such as severity, if you are experiencing pain or not.
Frequently Asked Questions About Flat Feet
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How do I know if I have flat feet?
We’ll tell you!
There are various ways of assessing the flatness of feet that professionals use but they can be hard to perform without the training and knowledge that health professionals possess. Ultimately if you are concerned about the shape and flatness of your feet and think they may cause or are causing you problems the best thing to do is to get them checked.
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Will my flat feet cause me problems?
Flat feet exist on a bit of a spectrum from mild to severe. The most important thing though is how the foot functions. Many flat feet are highly functional and will not cause issues over a lifetime particularly if you regularly do strengthening exercises to offset the extra work some muscles are subject to as a result of the lowered arch.
The trouble in many cases though is that the way flat feet functions lead to long terms deterioration of joints and tendons. In some cases by the time the injury presents a lot of the damage is done this is why it is best to get assessed and make sure you are on the path that avoids such future problems.