Atlantic Coast Chiropractic

The Pronated (flat) Foot, whats the big deal?

 

When a foot is severely pronated, or flat, it means its arches have fallen. Flat feet are less shock absorbent and make for a less stable foundation for everything above it, meaning the bones, muscles, ligaments, and tendons of the entire body. Imagine that the left side of the foundation of a house is sinking down. It is going to effect the foundation all the way to the roof!

 

Feet are the body's foundation. Flat feet can cause serious problems all the way up the kinetic chain (foot to neck). Pronated feet can cause any of the following problems: foot pain, heel pain, knee pain, hip pain, low back pain, shin splints, and even neck pain. Women with flat feet are 50% more likely than those without to have low back pain.

 

Biomechanical problems also exist when one arch is lower than the other, creating asymmetry. As with my house analogy above, when one arch has collapsed more than the other, it will cause the knee of that side to rotate inward, the hip to fall so that one hip is lower than the other, and will then cause the entire spine from the low back to the neck to compensate. 

 

Imagine when you were a kid building one block on top of the other. If one block was put on top of the other, offset to the right, then when you put the next one on, it will have to be offset to the left to try and keep the center of gravity in the midline so the structure stays erect. This is exactly what happens to the body when one arch collapses more than the other, compensation.

 

This fault in the foot will cause the muscles and tendons to work harder, yet less efficiently to make up for the imbalance. This is what leads to inflammatory conditions such as plantar fasciitis, shin splints, patella tendonitis, and strains of the spine! What causes pronation or flat feet anyway?

 

The connective tissue or plantar fascia on the underside of the foot is critical to maintaining the foots healthy arched shape. Injury and certain health conditions can cause the fascia to stretch out and flatten, but so can everyday, ongoing stressors like walking and standing. Repetitive, low impact force over time can be just as devastating as a sudden, high impact force. Every person is at risk for flattened feet. Once the fascia stretches out, it is unable to spring back, PERMANENTLY! 

 

The biggest risk factors of developing a pronated foot include being overweight, history of pregnancy, having diabetes, and aging in general. Some of the most common causes of flat feet are from injury like a torn ligament or broken bone in the foot. Stress over time of everyday activity like jogging, walking, and standing for long periods. Lastly, some people just never develop an arch, this is called a congenital anomaly and is a big reason a lot of children suffer from severe growing pains, Osgood Schlatars, and tendonitis. Every child starting from the age of 6 should have their feet examined to make sure their arches are forming. Most Pediatricians do not examine the muscular skeletal system with the exception of a basic scoliosis check and for hip displacia as an infant.

 

It is highly recommended that not only children, but most adults have their feet assessed every few years to make sure the integrity of the arches in the feet are being maintained. Early detection can be the key to not only preventing chronic injuries in the future, but preventing further decay of the arches. 

 

If pronation has already occurred or the arches integrity has been compromised, getting analyzed for custom inserts is the gold standard of management. I rarely recommend over the counter inserts. The biggest reason being that each foot on every person has slight variations and if you are not getting a proper mold for your foot, not only will it not help your feet, it can lead to fast deterioration of the arches. Also, if you do not need orthotics and you just go and get a pair because you think they are good for you, you will actually be making the muscles weaker and end up causing injury.

 

At the end of the day, be proactive when it comes to your feet. Have your children and yourselves examined every few years by a qualified health care professional. If you have had any types of pains that have not resolved within a few weeks go get examined as chronic injuries, especially in the lower extremity can be very difficult to manage. Lastly, be sure to not just play the guessing game and try to get a generic support without knowing exactly what is going on with your body as you can do more harm than good!

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