Am I flat footed?

I am often asked “Am I flat footed?”  My answer is, in most cases, “It is not how flat nor how high your arches are, but rather how much are your feet flattening during activity?”  The motion of flattening is what is most important.  Everyone is suppose to flatten or pronate but it is typically when we excessively flatten/pronate that we get into trouble.

The newest marketing trend is to advertise a shoe for a particular problem.  Although certain features in a shoe may indeed help such problems, it is impossible for one shoe to help everyone with the same problem.  That is, there are many types and reasons for flat feet.  No one shoe can suffice for all. However, there are some features in shoes that generally assist those with flat feet.

For example, some shoes have motion control and some not.  One brand of running shoe we carry is Brooks because they offer neutral, moderate, and maximum support.

Understanding different shoes affect your feet in different ways, allows you to look for certain features within the shoe itself. 

Those with feet that are excessively flattening, should look for a shoe that has some type of motion control. How much motion control will depend on your specific condition.

Typically, look for a shoe that has a steel shank and rigid heel counter. If unsure whether or not the shoe has a steel or stiff shank, try bending the shoe. If able to bend the shoe in half, it does not have a stiff shank. The shoe should ONLY bend where the ball of the foot bends. 

A rigid heel counter (the material around the heel) is helpful as it will assist in preventing the heel from everting too much, which is common in extremely flattened feet.

Also, look for support in the arches as well as a rounded sole in the front. This allows for easier push-off without jamming the ball of the foot.

Lastly, a shoe with a little heel is beneficial. This will position the foot into a more supinated position. Zero drop shoes should be avoided as most flat feet have a tight achilles tendon. Zero drop will put even more tension on the tendon.  

If any part of the foot during motion is not pronating or supinating as it should be, along with being completely symmetrical in timing, trajectory and speed of motion, then a problem will likely occur somewhere along the kinetic chain (the foot to the back).  We are essentially walking robots.  Machines that move require all the above.

Some feet look like “flat feet” and some like “high arches”.  The appearance is very subjective. Of course, when you see it flattening or flattened with stance, you’ll know it.   Again, usually, what is most important is the action of the body during the activity.

So should “flat feet” be biomechanically treated with appropriate shoes and foot orthotics?  

In most cases, yes. However, be careful of over the counter inserts as some only provide cushion and will not stop the foot from over flattening. 

We recommend seeing a professional who can assist you in finding the right combination of shoe and orthotic, whether it be  over the counter or custom molded. 

In order to walk or run we need to pronate.  Pronation (sometimes as referred to “Rolling In” of the arch) is a normal function.  Pronation is something like a shock absorber in a car.  When the foot pronates, it absorbs the weight of our body like a spring.  It is thought that over pronation leads to many painful conditions musculo-skeletally.  Many times if the over pronation is limited, the painful condition subsides and development of arthritis, bunion, bone spurs, etc. is diminished.

However, recent research has some questions about this.  First, they cannot define “Over Pronation”.  Second, controlling “over pronation” has not been shown (proof positive) to reduce injury in runners.  Keywords are injury and runners. (as well as just because something is not proven by man, does not mean it does not exist and thus should not be ignored).  Many of these studies are simply determining injury, not other maladies that come about with abnormal alignment.  Further, runner mechanics cannot be compared to average standing/walking and even running of the average Joe or Mary, who are not elite athletes.  Finally, many of these studies are not comparing apples to apples. This is not only true within the subjects studied but also within the devices used in which they compare them to all devices.

If you are “over pronating” or “rolling in” excessively, your body alignment may be off. This will most likely cause problems from the feet to the back.

How to Treat Over Pronation

To start, you can begin with a shoe that will “Support” your foot better.  This via a rigid heel counter (upper material around the heel bone) and a rigid shank (the sole of the shoe should bend at the ball of the foot only). The shoe should not be flimsy in the middle of the sole.  You have heard of steel shank boots, well it is the same concept.  Also, be sure there is some cupping of the heel and has some arch support.  Lastly, the fit is very important.  The ball of the foot by the big toe should be at the widest part of the shoe where it will bend when propelling your body forward.

A pre-made insert arch support can sometimes help.  What type?  Well,it is best to get a professional to help as there are many different types for all the different types of feet.  There is not one insert for every foot.

A custom molded foot orthotic may be best.  Why?  A custom orthotic is made exactly to your feet aligning. All of your arches and overall your foot to your leg and all the way up.

Muscle strengthening may help as well. However, this needs to be done consistently to be beneficial.