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Your Feet: Gateways to Your Knees, Hips and Back

Telma Grant, P.T. Private & OHIP physiotherapy and Chiropractic. If you're in pain, call us. We can help.

Question: Telma, I am starting to get the idea that I should come and see you if I have flat feet and let you examine my feet. I have enjoyed three articles on flat feet. How do you mean that flat feet can cause a problem in my knees, my hips and my back? I do not quite understand that.

Put down the newspaper and stand UP. Take your left foot, roll the arch in and keep it rolled. Now walk. Right away you’ll feel a pull in your leg, either in your knee, hips or in your back. This is an example of how a flat foot affects your walk, and how your walk will, in turn, affect other areas of your body. A person with flat feet is actually walking on his/her arches. Multiply this little demonstration by the number of steps a person will take in life, and the picture for complications from flat feet becomes very clear.

Everybody rolls in on their arches when they walk, but it’s only for an instant and only to transmit the weight from our heels to our toes for the push-off. Walking normally, the heel will strike and then we roll through the mid-foot, it flattens for an instant, but then we push off again we should be pushing off with the toes.

But a flat foot will cause the walker to push off the flattened arch. A strain on the knee results because the motion pulls on the knee. If left uncorrected, the muscles running from the knee to the hip are affected. Now hip pain will surface. If left uncorrected the pain will spread to the back and the body will try to compensate. Depending on the “solution” the body tries, neck pain and headaches could be just around the corner. Another possibility is that a flat foot will predispose the sufferer the heel and foot problem and we talked about that in the last article.

Through writing about this condition, I hope I have made my readers more aware of the dangers of leaving it untreated. We learned that children can be helped and the good news is that physio will also help adults.

Where the foot is flattened because the person is actually walking on their inside arch, but the arch remains in good condition, orthotics are critical and support that arch and stop it from flattening any further.  I do, however, suggest physiotherapy as a treatment before jumping into orthotics.

Why? Orthotics will not correct the muscular imbalance that has caused the flat foot. The physiotherapist will examine the foot, your knees and your back and will emphasize muscles that help to stabilize or correct the flatness of the foot. The most important sets of muscles are the pelvic, hip, back, and abdominal muscles. By training those muscles to be a little stronger, we can help support the hips, the back, the knees and, ultimately the flat foot. The numbers are promising: in 80% of cases treatment will correct the problem.

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Do flat Feet Need Treatment?

Telma Grant, P.T. Private & OHIP physiotherapy and Chiropractic. If you're in pain, call us. We can help.

Question: Telma, what I don’t understand is, why do I need to see a physio if I have flat feet?
Did you know that all children have flat feet until about two years of age? They look like they have flat feet and this is partly due to the fat pad in the inner arch of the foot. We call this the longitudinal arch. In other words, the arch is not fully formed until age two. All children under 2 have flat feet. When considering treatment, we are talking about the child beyond age two and older who has flat feet.
First of all what are flat feet? In medical terms, we call it pes planus. A pes planus or a flat foot is a foot that rolls in. If you look at a person from the back, you see that they are taking more weight on their inner arch then they should and therefore the foot flattens. This is why we call it flat foot.
A flat foot affects how that person walks, you can see this with a computerized gait analysis. The way the weight is taken by the foot changes and if you watch that person walk.
There are three parts to walking. First, the heel strikes the ground, then we roll through the middle part of the foot and then we push off with the first and second toes. This is normal.
When a person has a flat foot he/she takes too much weight through the heel on the side of the foot that is flat. You will hear, what is referred to as the elephant foot, slam, slam, slam. The heel hits much harder than it should. You can also see this in the gait scan because there is a red area under the heel. With time this will put a strain on the spring ligament under the foot, what we call the plantar fascia and the person could come down with plantar fasciitis or heel spur syndrome.
The other way patients will present with flat feet is that they do not heel strike very well. Instead, they roll into the inner arch and push off. You can see this on the gait scan as well.
With this kind of patient, the problem will not be as much plantar fascia, but the problem will be further up the chain. In other words, if the foot is not taking the impact of the ground well, the problem will reflect in the knees, the hips or the back.
If you have a flat foot, it can put a strain on your heel itself. This may give you a heel spur syndrome or may lead you to have knee/hip and back pain.
Ask about our free gait analysis.

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Adults with Flat Feet: It Gets Complicated

Telma Grant, P.T. Private & OHIP physiotherapy and Chiropractic. If you're in pain, call us. We can help.

Question: Telma, why do I need to see a physiotherapist if I have flat feet?

 

Let’s recap what, exactly, the term “flat feet” means. In medical terms, we call it pes planus, or a foot that rolls in. If you look at a person from the back, you see that they are taking more weight on an inner arch and, as a consequence, the foot flattens you have observed an instance of flat foot. Initially this may not sound like a condition of grave concern but when on considers that a flat foot will affect how a person walks in combination with how much time us grown ups actually spend on our feet, a flat foot has very important implications. It will affect how we walk and, ultimately, problems may develop elsewhere in our bodies.

The observer can see the flattening but a more detailed understanding of each flat-footed person’s condition is possible with a computerizes gait analysis. The client will walk through this examination; the weight of a person is taken in different measures by their feet as he/she walks. Walking may seem like a simple activity, but there are three distinct parts to the action. First the heel strikes the ground, then we roll through the middle part of the foot and then we push off with the first and second toes. This is the normal step of a normal-footed person. When a person has a flat foot walking is very different.

Specifically, two things will happen:

They take too much weight through the heel on the side of the foot that is flat. You will hear, what is referred to as “elephant foot”: as it slams, slams. The heel hits the floor much harder that in should. I’ve actually seen this as it happens in the gait scan: a red area will show under the heel. With time this will put strain on the spring ligament under the foot – – the plantar fasci – – and the sufferer could develop plantar fascitis, or heel spur syndrome.

The heel does not strike very well, and the walker will roll into the inner arch and then push off. This is also very clear on the gait scan. With this particular patient, the complications move further up the body., The foot is not taking the impact of the ground well, creating the potential for knee, hip, and even back problems.

Adults tend to take their feet for granted and, on the surface, having a flat foot doesn’t sound like such a big deal. But left untreated it can lead to something as “small” as heel spur syndrome, as nagging knee problem or persistent back pain that actually limits your activity level. The best solution is to see your physiotherapist for an examination. If you have a question for Telma please contact us.