rehabbing flat feet

“…so how do barefoot hikers not have flat arches, if we all need some support?”

Do we all need support?

Watch Haille Gebrselassie , and you can see that not all of us Need support.

His “issue” is over-pronation, not what you are asking about, but “Support” in general is the big question.

That is my primary issue with the footbeds. Aren't your feet supposed to be able to achieve better form without an appliance of some sort?

> Flat arches are caused by weak feet, aren't they?
Nope.
In many cases they are caused by genetics.

> So, how does an appliance help strengthen my feet?
Usually, adding a crutch weakens the muscles.
And 600,000 years of human evolution was largely achieved with bare feet.

> if we all need some support?
Oh, I need some support all right. Please send all donations to …

The whole Nike concept of 'arch support' is now completely discredited. It never had any logic; it was pure marketing spin to get sales.

Cheers

My feet used to be flat. Had bad plantar fasciitis too.

Now they have arch. Havent had PF since I began wearing the hard urethane orthotics to put arch back in foot 20+ yrs ago.

Its a long long story, but yes it works and does wonders. Reasons for arches to fall vary, mine involved lifting heavy weights, but the PF and falling arches had started years before that, when I was 18 and freshman in college.

A fallen arch requires the ankle to roll slightly, which makes the body shift the knee, and the hip as well to compensate. People experience all kind of ankle, knee, hip, and back issues from it.

Someone elsed idealized arch for a foot, is better than no arch at all.

>> I get pain on the top of my right foot if I hike too far, extending into my ankle.<<

Have you gotten a proper diagnosis? Are you making the connection between flat feet and the pain in the top of your foot or have you seen a doctor and had xrays etc.?

I have suffered with a pain in the top of my foot for many years and found out that I have arthritis there (there's a joint there). I don't have flat feet but have had a pair of custom insoles made with an exaggerated arch support that actually opens up the joint on top of my foot and greatly relieves the pain. It took a while to get used to the over-sized instep support but the pain was relieved considerable so it's worth it for me.

I don't know about the 600 thousand years of foot evolution, but I do know that it only took me 60 years of abuse to wreck my feet. I'm glad for the custom orthotics.

I haven't been to a doctor specifically. However, I am a veterinarian, I read radiographs every day, and I have radiographed that foot for an unrelated problem. I know there's no arthritis there. The issue is in the soft tissues on the top of the foot. The problem gets better with training, and is far better than it used to be, just by reducing the support of my shoes. Being able to stretch and wriggle my toes improves the pain while I'm walking. Sometimes I find myself walking with my toes raised, and I have to curl and grab the ground with them.
The yoga has straightened my toes a lot and allowed them to spread out so they aren't rubbing nearly as much. Everything I'm doing seems to be helping, I'm just skeptical about the footbeds. I don't want to be dependent on them if I don't have to be.

Diane, email me.

I also posted a couple of foot exercise videos on my nascent blog backpackerPT.com that actually are specifically for the posterior tibialis…the muscle responsible for the dynamic control of your arch.

Let's talk in a bit more depth about your issue…if the pain is on the dorsum of your foot and extends proximally (how far?) then I doubt anything having to do with the arch is the issue.

Jenmitol AT gmail DOT com

I'll do that, Jen, as soon as I have access to a real keyboard. My screen keyboard is too difficult to type on.

My advise for arch supports is to gradually thicken the support until it feels comfortable. Then leave it at that level for the better portion of a year and then gradually reduce the thickness.

I had collapsed arches and plantar fasciitis. I resolved the plantar fascitis with soft sole shoes. However the arch was harder. None of the arch supports I could find worked. None appeared to have a thick enough arch support for my needs. So I made my own.

I took a standard flat insole and applied silicon rubber where I needed it. Covered it with paper, put it in my shoe and then stepped on it to shape the rubber before it cured. I did this repeatably until I felt it was thick enough. Just under 1/2" which is much thicker than most arch supports in the stores. Silicon rubber that thick is quite hard but I could walk around comfortably all day.

About a year and a half later the arch support was starting to bother me so I removed them and found my arches no longer needed support. The tendons in my arch were initially very tight. Over time the tightness went away. Occasionally about 1 once or twice a year my arch would collapse. when that happened the arch supports went back in only long enough to get the foot to heal.

In the years since I have found the thick heals of standard shoes were causing most of my problems. Since switching to flat sole shoes about 3 years ago have not had any more collapses and I have not been using arch support.

I think the thick padded soles I was using eventually did cause an injury and my arch collapsed. Later that injury spread to my heal. the tendons didn't heal until I took off all the load on them with very thick supports. And the occasional re injury did not stop until I got flat sole shoes.

I agree with Roger and the modern consensuses about the use of arch support in shoes.

There are too many case of people adjusting to walking without arch support and finding their issues goes away.

I do understand that there are many foot doctors that disagree on this subject, but I have seen too many people get rid of their foot problems by getting the junk out of their shoes.

Heel lift and arch support has been aggravating the problem instead of helping.

I know my problems went away when I got rid of the arch support and the heel lift.

I definitely feel better without the heel-to-toe drop. I've quit the arch risers, and I'm using Jennifer's hip stabilization exercises to correct the severe pronation I had developed–that is definitely helping the pronation.

The pain I have on the top of my foot is unaffected by these exercises and the change in my shoes. Unfortunately, not walking makes the pain go away, but I'm not prepared to stop hiking altogether–it has way too many other benefits in my life. I haven't consulted a medical professional on it, mostly because I live in an area that is far from specialists, and those that are here are dedicated to elder care, not sports medicine.

Diane, a quick and dirty thing to try might be metatarsal pads. If they don't help you can remove them. It depends on what is causing the pain, of course. Metatarsal pads are supposed to, amongst other thing, prevent some pinching in the long bones in your mid foot. You could try it I suppose.

Dianne: because of surgery when I was a child, my left foot is flat. I mean, I have no arch at all. this is an extreme case, but here's what I've found out: there's no structure in my foot for me to establish an arch. Simply can't be done. By analogy, there used to be a popular book by Aldous Huxley (of all improbable people) that advocated 'strengthening' your eyes through a series of arduous exercises promising to improve your sight. Now of course we know that distortions in the lens of the eye, not 'weak eyes', cause poor eyesight. No amount of exercise could ever address the problem. It's the same, in some cases, with flat feet. Roger is right that often genetics grant you flat feet. This isn't a weakness or a moral failure of flat footed people.

In my case, orthotics have made a huge difference. Roger is also right in pointing out elsewhere that introducing artificial structure in your feet will inevitably effect your whole anatomy. Trying to solve a problem in your feet could lead to problems in your knees, hips, back, etc.

In my case, orthotics vastly improved issues in my knees and feet that were caused by the poor structure in my left foot. And this is over a decade. I had to introduce structure where there 'naturally' wasn't any; this improved my overall anatomy.

sorry for this rambling response, but I think the point that I'm trying to make is that people have to explore their own solutions to foot problems. And it's complex, and there's no one answer.

I have never understood why flat feet are a problem. Does it hurt? My boyfriend has flat feet and he can hike all day long. I've never heard him complain about his arches hurting or anything. But he does parrot the whole "I need arch support because I have flat feet" thing. It always makes me wonder why. What would happen if he just walked on his flat feet? Would his feet crumble to dust?

I have heard of some people after walking in minimalist shoes for a while having arches form from flat feet.

Yeah, and if you stop wearing glasses you'll end up with 20/20 vision. Because glasses are, you know, a crutch and probably caused your poor eyesight to begin with.

Well, having presbyopia, I think my glasses ARE a crutch to some extent.

Lack of arch, puts the the whole body out of whack. Ankle rolls to side a bit, knee and hip and back all have to shift to compensate. Many peoples back , hip, and knee pains, can start with their feet.

"I have never understood why flat feet are a problem. Does it hurt?"

It can hurt and for me it was quite painful to stand all day at work. However not everyone is the same.

Actually the structure of your arch and strength is tied very strongly with your leg muscles, specifically your calves. If your calves are tight, like mine were, you can develop plantar fasciitis, as I did. Four weeks of PT and stretches, exercises and other things to relieve the pain and swelling, and damage I did, has both improved my feet/arches and most of the work has been on my calves. Lots of deep muscle tightness and muscle knaps caused me quite a bit of problems with my feet.
And I never knew I had flat feet, they are actually described as pretty average by my PT doc, but evidently the muscles and ligaments in your legs are key to keeping your feet healthy.

Well….

I'm a huge proponent of the if-it-ain't-broke-don't-fix-it philosophy.

If you have flat feet and you have problems somewhere along the lower kinetic chain (low back, hips, knees, feet) then by all means, go see a COMPETENT PT to see if the flat feet actually have anything to do with what's going on (it won't always).

Most people who have flat feet have had them for years and years…so the arches may or may not be a contributor.

If you have flat feet and have no problems, then for the Love of Pete, don't try to fix it. Your body has adapted to how it is and the one thing our bodies REALLY don't like is change. Of any kind. Leave it be…..

If you work the muscles in your calf, particularly the tibialis posterior (see my foot exercise videos on my blog backpackerPT.com), then sometimes you can support the medial arch…sometimes you can't.

As for arch supports – just remember, the arch of your foot is NOT supposed to bear weight – it is supposed to fall a bit when you put weight on your lower extremities. It is the natural spring of your body when you stand…or land, or jump, etc. If it is already flat when you are just standing, or heaven forbid sitting, then you don't have much of a shock absorber in your foot. BUT…if you put a big arch under your foot, such that there is actually weight going through your arch (like many of the over the counter and even expensive prescription ones do), then you still don't have any spring/shock absorption and are just causing different problems, in addition to the ones you probably already had.

I have yet to meet a podiatrist who I agreed with, so yes, you may have heard different things from that profession. But this is what we know from biomechanics, kinesiology, anatomy, clinical research and my own professional experience.