Flat feet, Collapsed arches. Does it matter? Who cares?

Big on the news lately has been about a boy who was disqualified from running in a finals race as he was running barefoot. A good mate posted something about it which ended having a few comments on a few difference topics.

I'm not here to discuss whether or not he should have been allowed to run, but let's take an objective view of foot structure.

The foot has 26 bones, a good number of joints and many ligaments and tendons (don't ask me what they are, I've forgotten most of them). Babies are born in the purest of ways structurally and move in the purest unadulterated form. They are born with soft, malleable, mouldable feet and are growing and changing all the time. As they grow, they are meant to grow spread out, almost in a "V" shape, wide across the toes. 

Feet are our foundations of our body. With nice strong feet, it sets the body up to have a good solid base. With patients that have altered foot mechanics or altered foot structure, it can cause problems all the way along the body's kinetic chain or the body's movement pattern. In other words, if you have altered foot structure, it can potentially causing compensations and altered movement from the feet up the body, and even up to the shoulder.

There is genetic flat footedness and acquired flat footedness. For the purposes of this article, I will be referring to acquired flat foot, or more commonly know as collapsed arch.

I'm my practice and from observation, a lot of people have been, in my opinion, wrongly diagnosed with flat feet. Sure, when they stand upright, their feet appear to collapse inwards, and the instep is flat on the floor (left picture). However when you get them sitting with their foot off the ground, you see that they have actually got a lovely arch (right picture). Is it true flat footed-ness then?

How many of them then, have been prescribed orthotics to help assist their "flat feet". Now don't get me wrong, orthotics do have their place and purpose, and I have referred patients to podiatrists for their expertise as well. However, clients get too caught up in their "label" and become over-reliant on their orthotics.  I believe they need to consider why they have been prescribed orthotics. Orthotics do help support feet but they also serve to alter movement. The old adage of "if you don't use it you lose it" applies. If you become too reliant on orthotics, the muscles of the foot do not work like they should and they start to get lazy. I recommend progressively removing orthotics with various activities and see how that feels, transitioning to eventually removing them completely and see how they feel. With the right strengthening program, and "freeing" your feet again, you might be on your way to get your feet working optimally again, the way they were meant to be.

In my next article I'll discuss foot structure with regards to footwear; whether or not you are having the appropriate footwear and considerations for choosing footwear in future.

Thanks for reading!