Flat foot is a term that is often used to describe the low arched foot. In the past a low arched foot was almost always considered to be a ‘bad thing’. However, as science has evolved we have a better understanding of the foot and now know that a ‘flat foot’ often has no detrimental effect to the position and function of the foot and leg.
Foot pronation is the term used to describe the inwards tilt of the heel and lowering of the arch of the foot. This is an essential movement which takes place during normal walking and running. Sometimes the foot may over pronate or under pronate and either of these foot positions may result in numerous injuries surrounding the foot, knee, hip, back and leg. Examples of such injuries include; shin splints, plantarfasciitis, mortons neuroma, bunion, arthritis, tendinopathy or stress fractures.
An experienced and knowledgeable clinician will carry out a biomechanical assessment in order to clarify whether the client over pronates or under pronates. Video recordings taken of the client running and walking are not sufficient on their own to diagnose foot type or injury. An accurate clinical assessment of the foot/ankle and lower limb will highlight inaccuracies in joint and muscle range and function. This should include a hands on practical assessment which can be used in conjunction with technological devices, such as pressure foot measure devices and video gait analysis, to accurately understand foot function.
In general, an over pronated or under pronated foot may be considered a ‘bad thing’ when either foot position results in an increase in the stress applied to tendons, ligaments or joint capsules. The clinician will be able to determine which soft tissues are under additional stress and this can be demonstrated by a reduction in joint or muscle flexibility and/or function. In this situation it is important to restore foot posture, with either the prescription of foot orthotics or foot mobilisation techniques, in order to prevent or resolve an injury.
If the low arched foot (previously named ‘flat foot’) is not resulting in pain, loss of balance or is related to loss of joint or muscle range of motion or function in the joints of the foot, knee, and hip, there is no clinical requirement to restore foot posture. If it’s not broke, why fix it?!