What are flat feet?

Should I be worried about flat feet?

“Flat feet” and “fallen arches” are terms often used in discussions about foot pain and when deciding on footwear. 

But what exactly are flat feet?

Firslty, we need to consider your foot shape. Your foot shape is determined by many factors and there is a lot of misinformation about what is a normal foot shape, and what causes foot problems.

Foot Function

Our feet are required to perform two specific functions, which are as follows.

Feet need to be stable to provide a solid base of support and also to allow us to push off when we walk or run.

They also need to be mobile so they can absorb the jarring of our daily activities, sports and uneven surfaces.

How can the foot perform these apparently opposite tasks?

It’s all in the structure of the bones of the foot which allow us to roll in and roll out. 

If you do these motions in standing, you will notice the arch of your foot will increase as we roll out and flatten as we roll in. When we turn out, the arch lifts and brings the joints into a more stable and rigid position, this is called supination.  As we roll in, we flatten the arch and the foot becomes more mobile or sloppy, and this is called pronation. 

So by having the ability to control these movements we are able to have both a strong foot to push off with and ability to have the shock-absorption when we need it too.

So what are flat feet and fallen arches?

Flat feet and fallen arches are often interchangeably used to describe feet that flatten out but they are actually technically different situations. 

When you look at your foot in mid-air, the vast majority of us will have some degree of arch. However, a small proportion of us are born with a boney foot structure that has no arch at all.

These people have true “flat feet”, so the foot stays flat whether they are standing on them or not. This of course means they will have problems arising from the inability to absorb impact and will need to get advice about how to cushion their feet.

For the rest of us, our feet will change in shape when we stand on them and the arches will adopt varying degrees or change. About one third of us have feet that roll in or “pronate” to different degrees. If the amount is significant they are commonly said to have “fallen arches” or “over-pronate”.

Are fallen arches or pronating feet a problem?

This is where misinformation and incorrect advice abound. Although there is a plethora of information available to us through our access to internet and social media, much of it gives us mixed views and incorrect information. 

Opinions on injuries, treatments, footwear and management are passed on with what are hopefully, well intentioned motives, but there is one very important over-riding fact that we all need to remember. We are all individual.

Two thirds of the population are pronators and not all have problems. As mentioned earlier, we need feet that are able to be able to both pronate and supinate. Injuries arise when tissues are strained or overloaded to a point where soft tissue damage develops and then pains start.

Do I need to do something about my feet?

There are three factors that determine if our feet start to give us problems.

• Our anatomy; how we were born.
• How we move; our “bio-mechanics” 
• And what we do; the loads we put on our feet.

The first one we are stuck with, but the latter two are the variables. 

Some people may have minimal pronation but decide they want to take up walking or running for fitness and develop problems. Others may be marked pronators but are happy with their sedentary hobbies and have no issues at all.

As everyone is different, there is no one straight answer to problems that arise.

Signs of foot pain

If you start having aches or pains then it is best to seek a full assessment of your problem from someone who can look at your biomechanics, or the way you move as a whole. It is important to realise there may be reasons why you pronate that need to be addressed. If the contributing factors are not dealt with, then your problem will not be truly solved.

It is always better to seek help as early as you can to make recovery quicker, helping you get on with what you want to do with a smile!

Back In Motion practices offer a free initial twenty minute assessment where you can have your feet or any injury for that matter assessed by a qualified physiotherapist without obligation. In this assessment the physio will determine a likely diagnosis and a course of management. You can then choose whether to progress with treatment.

Author

Max Kavanagh, Physiotherapist at Back In Motion Brighton