Flat foot/feet

 The foot as a region of body that has a very small surface, consists of a large number of different bone, muscle and ligamament structures and transfers a great deal of load on a daily basis can be an extremely problematic region. A properly built foot has three arches that keep its stability and offer an optimal transfer of load through its whole lenght and in that way enabe correct and pain free movement. The three arches of the foot are, the medial longitudinal arch, which goes alongside the inner lenght of the foot, the lateral longitudinal arch, going alongside the outer lenght of the foot and the transversal arch of the foot, which goes along the width of the foot at the base of the metatarsal bones. Each of them secures the correct biomechanics of the foot and lowering of any of them can indicate weakness or deficit in certain muscle groups of the foot and can lead to problems and pain in the feet which can then greatly affect the quality of movement and can lead to problems in other parts of the body, eg. knees, hips, lower back.

Flat foot is thought to be the most commonly aquired deformation of the human movement system, it affects up to 70% of the population. It often occurs with certain professions and as a result of a certain lifestyle, a sedentary lifestyle. Work conditions, quality of footwear, amount of physical activity, being overweight, etc. can all be factors which can percipitate this state. In order to optimaly fulfill its role of absorbing and transfering load during movement the foot has to be mobile and elastice enough and it is exactly the arches that provide that function to the foot. During standing and moving the foot can take on a valgus or varus position depending on which arch starts falling down, if the medial arch lowers the foot rotates and falls inwardly into a valgus position and if the lateral arch lowers the foot then procedes to rotate and fall outwardly into a varus position. What is specific of the transversal arch lowering or falling down is that the toes start spreading.

Lowering of any of the three arches undermines the mechanics of the whole foot and with time it can lead toward developing other foot, knee, hips or even lower back deformations. Pain, tingles and loss of sense in the foot,  lower leg and foot muscle soreness and weakness are triggered during long perids of either standing or walking due to the fact that the muscles take on the role of the arches in supporting the foot and are therefore overloaded. Blood flow problems, degenerative changes in the foot, knee and hip joints can develop and a flattened foot can also be one of the factors in getting injured during sports activities, eg. the valgus colapse of the knee due to an inactive and lowered medial longitudinal arch of the foot.

Flat foot problems are generally treated with a conservative approach, implementing strenght exercises for foot and lower leg muscles, exercises aimed at pulling the arches up again and regaining their elasiticity. The process can sometimes cause a bit of discomfort, especially if the arches have been inactive for a longer period of time, so when they start getting active again it can be a bit painful, but the discomfort sunsides very quickly. Orthopaedic pads made specifically for flat feet according to each patients needs are another solution for this deformation. They are commonly advised to younger population due to the fact that their arches respond easier to the use of pads and they give better effects. However, it should be stated that only through use of kinesiotherapy methods, ie. proper foot and lower leg muscle strenghtening, balance and elasticity exercises of the foot a longterm solution of this deformity can be found.

Prevention: choice of quality footwear, correctional exercises for foot and ankle mobility and strenght of the foot and lower leg muscles with individuals whose working places require long periods of standing or walking, if possible avoiding long periods of standing or walking on flat surfaces, regular physical activity, maintaining a balanced body weight, etc.