Hello and welcome to this episode in our series. Today, I’ll be talking about foot posture and comparing the difference between a flat foot posture to a high arched foot posture.
There are two extremes of foot posture, so we have a high arch foot type and a low arched foot type, and there are lots of variables in between. The ankle joint is a very complex joint because it moves in three planes of movement and this is different to any other joint in the body. This is what allows us to walk on two feet. So the first foot posture is a low arch foot type or a flat foot posture. With this foot posture, it’s technically known as a pronated foot type, everted foot type, or a pes planus foot type.
There are varying levels of this foot posture and there’s also varying levels of discomfort. Some people will be symptomatic and have pain, whereas others might not be. with this type of foot posture, one of the things that is common all across the board is that this foot posture has a low arch profile during the walking cycle. So a loss of the arch while a person’s walking. One of the other characteristics is the heel tilting inwards, and we can often see from the rear foot or from the back of the foot that the foot sitting in a slightly external position, so we can often see too many toes or we have a tow drift. One of the other things that happens with this type of foot posture is we get external rotation of the tibia and internal rotation of the femur. So it changes the dynamics of how our lower limb functions during our walking cycle.
The other type of foot posture that we see quite commonly is a high arch foot top. So this is technically known as a supinated foot posture, an inverted foot posture, and a pes cavus foot top posture. So again, there’s different levels of this condition or this type of foot posture. And across the board, what’s usually seen as a very high arch foot type. We can also usually see the heel tilting outwards and we can see that the foot tends to load up more on the outside border of the foot. So we get more loading through the lateral column of the foot. With this foot type, we get internal rotation of the tibia and external rotation of the femur. And again, it changes the dynamics of how the lower limb functions during our walking cycle.
There are different types of musculoskeletal injuries that are associated with both types of foot posture. So with the high arch foot posture, we more commonly see stress fractures developing because of that loss of ability or reduced ability to absorb shock. They’re also more likely to develop conditions like plantar fasciitis, tendinitis in the ankle, and several other musculoskeletal conditions. There can also be association with knee and lower back pain. The lower arch foot posture also has different conditions that can develop. So one of the most commonly seen ones is tendinitis in the ankle through the tibialis posterior tendon. Plantar fasciitis, again. This foot posture is also associated with shin splints, which is also known as medial tibial stress syndrome. And again, several conditions that are more common in this type of foot posture, including knee and lower back pain.
Genetics plays a big role in how our foot posture develops. So in children we tend to see more of a flexible foot posture. But if parents are concerned that their children have painful flat feet, then it’s important to have it assessed as there is different conditions that can develop such as tarsal coalitions. It’s important to have that ruled out. In adults with symptomatic flat feet, it tends to be the tibialis posterior tendon that causes the problem. It can be a multitude of issues that can cause pain and flat feet, but that one’s a common one. The Tibialis posterior tendon’s main function is to support the arch. So with people with a lower arch profile, that tendon tends to work harder to try and bring the arch up. In the latest stages of this condition, the tendon can become degenerative and it loses its ability to support the foot, so we seen more of a deformity developing. It’s important to have that assessed sooner rather than later to prevent it getting to the point where we have those long-term deformities developing.
At your podiatry appointment, what you should expect to see is a full biomechanical assessment being performed. This involves checking your range of motion and doing a thorough gait analysis where we’ll observe you walking. Generally speaking, this type of foot posture will be assessed and it will be determined whether you need something called a custom foot orthotic. This is a device that supports the arch and also controls the rear foot biomechanics by putting your foot into a more neutral position. There are different types of orthotics and that that will be discussed at your appointment.
Orthotics is similar to glasses in that when you have them in your shoes, they provide you with support. However, when you take them out, the foot will grow back to its original position. So they don’t correct the foot posture long term, they provide support while being worn. In more severe cases where the deformity is quite progressed, sometimes it requires a surgical referral. So, if that’s the case, then we’ll often look at referring things on. An exercise plan will also be developed at your podiatry appointment to strengthen muscles that are being overused, and an orthotic device also to help to take the pressure off over-used and over-worked structures that might become painful. So, generally speaking, we look at more conservative treatments first.
It’s important to have any form of foot or ankle concerns addressed early. The advice given in this video is general in nature. And if you are experiencing any foot or ankle pain or concerns, seek an appointment with a qualified health professional. Bookings can be made with one of our podiatrists via our website.