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Are "sagging" arches a sign of flatfeet?

Posted by H.L.W. on 9/12/01 at 01:33 (059942)

I have no pain in my feet or lower back,but whenever I apply weight
my arches seem to 'sag' not enough for my whole foot to show up
in a foot print but compared to other peoples feet my look funny.

Thanks,
HLW

Re: Are "sagging" arches a sign of flatfeet?

Ed Davis, DPM on 9/12/01 at 22:34 (060066)

It is possible to have low arches and have no problems whatsoever. The famous Olympic runner of yesteryear, Jesse Owens, was reported to have feet as flat as pancakes. Arch height is an architectural feature of your feet not necessarily related to function. On the other hand, feet that roll in (pronate) excessively can often lead to strain of the plantar fascia and other mechanical problems. Overpronation and flat feet are terms that have often been used interchangeably but really refer to different entities. Overpronation is a functional as opposed to a structural entity.
Ed

Re: Are "sagging" arches a sign of flatfeet?

Pauline on 9/13/01 at 09:05 (060111)

Dr. Bavis,
To what degree 'off' normal for pronation would require treatment since the normal foot uses some pronation in a normal gait. Also how do you determine that the pronation isn't caused by a problem higher up such as extremity abnormalities that wouldn't necessarily be helped by an orthotic? I know the try and see method, but at the cost of orthotics is there another way?

Re: Are "sagging" arches a sign of flatfeet?

Ed Davis, DPM on 9/13/01 at 13:19 (060145)

There is no specific set of figures that can relate exactly how much pronation would be problematic. There are a couple of reasons for this.
First, people compensate for overpronation via different mechanisms and thus are able to function with differing amounts of abnormal motion. Second, it is just not the amount of pronation at the subtalar joint that is an issue but the amount of subtalar joint pronation expressed relatively to the amount of pronatory range of motion available. We often see more symptoms in an individual with a subtalar joint that exhibits a limited range of available pronation range of motion. When a joint attempts to function or move beyond its available range of motion, the additional motion must be provided by other proximate joints. The proximate joints, required to provide compensatory motion than may become problematic. A good biomechanical exam can take these factors into account such that one really does not need to resort to 'trail and error.'

Occasionally, some testing of treatment is still necessary and can be done via the use of a modified pre-fabricated orthotic which may be progressively modified and fine tuned in order to help find out 'what works' before proceeding with a custom orthotic.
Ed

Re: Are "sagging" arches a sign of flatfeet?

Ed Davis, DPM on 9/13/01 at 13:22 (060146)

The effect on joints 'higher up' can be judged, in part, by the biomechanical exam and in part, by performing gait analysis before and after using modified prefab orthotics.
Ed

Re: Are "sagging" arches a sign of flatfeet?

Ed Davis, DPM on 9/12/01 at 22:34 (060066)

It is possible to have low arches and have no problems whatsoever. The famous Olympic runner of yesteryear, Jesse Owens, was reported to have feet as flat as pancakes. Arch height is an architectural feature of your feet not necessarily related to function. On the other hand, feet that roll in (pronate) excessively can often lead to strain of the plantar fascia and other mechanical problems. Overpronation and flat feet are terms that have often been used interchangeably but really refer to different entities. Overpronation is a functional as opposed to a structural entity.
Ed

Re: Are "sagging" arches a sign of flatfeet?

Pauline on 9/13/01 at 09:05 (060111)

Dr. Bavis,
To what degree 'off' normal for pronation would require treatment since the normal foot uses some pronation in a normal gait. Also how do you determine that the pronation isn't caused by a problem higher up such as extremity abnormalities that wouldn't necessarily be helped by an orthotic? I know the try and see method, but at the cost of orthotics is there another way?

Re: Are "sagging" arches a sign of flatfeet?

Ed Davis, DPM on 9/13/01 at 13:19 (060145)

There is no specific set of figures that can relate exactly how much pronation would be problematic. There are a couple of reasons for this.
First, people compensate for overpronation via different mechanisms and thus are able to function with differing amounts of abnormal motion. Second, it is just not the amount of pronation at the subtalar joint that is an issue but the amount of subtalar joint pronation expressed relatively to the amount of pronatory range of motion available. We often see more symptoms in an individual with a subtalar joint that exhibits a limited range of available pronation range of motion. When a joint attempts to function or move beyond its available range of motion, the additional motion must be provided by other proximate joints. The proximate joints, required to provide compensatory motion than may become problematic. A good biomechanical exam can take these factors into account such that one really does not need to resort to 'trail and error.'

Occasionally, some testing of treatment is still necessary and can be done via the use of a modified pre-fabricated orthotic which may be progressively modified and fine tuned in order to help find out 'what works' before proceeding with a custom orthotic.
Ed

Re: Are "sagging" arches a sign of flatfeet?

Ed Davis, DPM on 9/13/01 at 13:22 (060146)

The effect on joints 'higher up' can be judged, in part, by the biomechanical exam and in part, by performing gait analysis before and after using modified prefab orthotics.
Ed