On your toes

Published 7:09 pm Saturday, July 3, 2010

If you have back, shoulder, hip, neck and even knee pain, the root of the problem might not be where you think.

The source of many aches and pains all the way up the body can be flat feet.

“When a foot flattens out it puts strain on different joints leading to the ankle, knee, hip and lower back,” said Dr. Matthew Dairman of 1Foot 2Foot Centre for Foot and Ankle Care. “It’s a chain reaction, so when you hit the ground it starts at your foot and works it way up.”

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As with most disorders, flat feet has varying degrees of deformity, disabilities and types. The basic problem is the partial or total collapse of the arch.

“In a foot with an arch, when the foot hits the ground the body creates a rigid lever to absorb the shock and allow you to go forward,” Dairman said. “When it flattens out, it doesn’t resupinate and causes everything else to be off alignment.”

According to the American College of Foot and Ankle Surgeons, symptoms often associated with flatfoot include pain in the heel, arch, ankle or along the outside of the foot, a turned-in ankle, pain associated with a shin splint and general weakness in the foot or leg.

Flatfoot typically comes in two different forms — rigid and flexible.

In flexible flat feet, the more common of the two, an arch can be made out, but when pressure is put on the foot it falls.

It can often be seen in children whose bone structure has not yet been solidified.

“We start seeing children as early as 4 or 5 years old to prevent it from turning into a rigid flatfoot,” Dairman said. “It’s the most common because children aren’t born with a rigid flatfoot. It’s the easier of the two to correct.”

“If you have rigid flatfoot it will look flat whether you’re standing or not,” Dairman said. “The joints have oriented themselves so you can’t resupinate regardless of what you do.”

Rigid flatfoot is considered more of a significant problem because of the pain often associated with the condition.

While most children who have flatfoot have flexible flatfoot, there is a condition called tarsal coalition in which two bones don’t separate as they should, and a surgery is typically required.

Surgical procedures are also often needed to correct rigid flatfoot.

“We want to guide patients to orthotics, appropriate shoes and to recommend better activities for their foot before we recommend surgery,” Dairman said. “Most everyone starts with orthotics though. They’re custom modeled. Just like you need glasses for your eyes, you need to get a prescription for your feet.”

Arch supports or orthotics are often needed for both cases of flatfoot, but there are many misunderstandings in the field, Dairman said.

“The concept of arch support is a huge misconception,” Dairman said. “Products like Dr. Scholls ‘arch support’ don’t give you the support you need. It provides cushion, but if it collapses to your finger it won’t do much to support your arch from falling when you put your entire body weight on it. You need something that will stop your arch from flattening out.”

With correct orthotics and arch supports, the chain reaction of problems can be corrected.

While “some people never need to get it fixed because it’s not a problem for them,” Dairman said, left untreated it can cause a chain reaction of pains, aches and problems all the way up your body.

“Getting flatfoot treated can make a big difference in your life,” Dairman said. “It can take a lot of stress off your body and makes getting around easier. It’s never too late to get it treated, and if we can catch it in kids we can correct it before it becomes rigid flatfoot.”