"Flat feet" is a popular reference term for the medical condition describing feet with collapsed arches. Flat-footedness is caused either by the body's inability to develop arches or by weak muscles that fail to maintain arches. While flat feet are usually painless, the ankles develop problems from turning in to compensate for the lowered arch. Proper shoes help the ankles to support the body and reduce leg pain associated with the condition.
The foot is composed of of 26 bones held together by 33 joints. The bones and joints, along with more than 100 muscles, tendons and ligaments make up what is commonly called the arch of the foot. The arches provide a spring-type system to assist in moving the body, as well as absorbing its weight over any type of ground surface. People with flat feet require walking shoes that incorporate arch supports that replicate the foot's normal curvature. Shoes can be tested by placing the fingers inside and pushing down. There should be firm support rather than soft cushioning. The fingers are then slid to the center of the shoe to feel the incline in the insole material. Flat feet require a shoe with such a built-in arch. Most shoes made specifically for walking by companies such as Asics, New Balance and Saucony have a built-in arch.
Custom Arch Supports
When over-the-counter walking shoe models cannot provide the proper support for the fallen arch, custom orthotics are required. Orthotics is a medical term used to describe special appliances that are placed inside the shoe to provide an artificial curvature that approximates a natural arch. In this case, the orthotic arch replicates the height and placement of the foot arch. A podiatrist or related specialist creates a custom foot support in either a rigid, semi-rigid or soft arch, with the firmness determined by the individual's orthotic needs. A walking shoe must then be selected that provides a perfect fit for the new orthotic arch support.
Over-the-counter walking shoes designed with higher insoles (the surface on which the foot rests) are better for flat-footed walkers, because the raised area allows the middle of the foot to rest higher, providing additional support for the foot and ankles. Because the arch is different in each shoe, each person will need to try on a variety of walking shoes to approximate the arch of his feet.
Specific Shoe Design
Podiatrists at the San Juan Foot and Ankle center recommend walking shoes that have motion control and a straight last (base of the shoe) to assist in stabilizing the foot when moving. Motion-control walking shoes have more support for the mid-foot. In addition, they have a reinforced heel and piece of cardboard that runs the length of the shoe for greater stability. Walking shoes on the market with moderate to maximum motion control include Asics Gel Foundation Walker, Asics Gel 4 to 8 Walker, New Balance 659 and Saucony Grid Integrity ST.
Custom wedges also belong to the category of medical orthotics. Custom wedges are prescribed when over-the-counter walking shoes have created tendinitis -- or the risk of this condition-- in the posterior tibial tendon by failing to provide the necessary support. According to the American Podiatric Medical Association, custom othodics including wedges are designed to control the abnormal motion your flat feet cause and can be used to treat foot pain, such as tendinitis. Depending on your foot type, wedges can be designed to promote inversion (turning inward) or eversion (turning outward).
- American Academy of Orthopaedic Surgeons: Adult Acquired Flatfoot
- San Juan Foot and Ankle Center: Walking and Your Feet
- Foot Vitals: Orthotics: A Complete Guide to Foot Support
- American Podiatric Medical Association: Shoe Inserts and Prescription Custom Orthotics
- American Academy of Podiatric Sports Medicine: Footwear: Walking Shoes
- New Atlas of Human Anatomy; Thomas O. McCracken, General Editor