Flat feet is a serious problem that, according to statistics, every second adult and child in our country faces. With it, the legs gradually lose their bending volume, the shape of the arch of the foot changes, and deformation (curvature) of the feet occurs. If corrective treatment is not started in the initial stages, then many changes may subsequently become irreversible.
In this article we will talk about factors that can provoke the development of flat feet, about the stages of the disease and how the right orthopedic shoes can correct existing signs of deformation and prevent further pathological changes.
Reasons for the development of flat feet
Flat feet very rarely develop out of the blue. Typically, such unwanted deformations occur due to:
- wearing uncomfortable, low-quality shoes;
- low physical activity.
- being overweight;
- constant increased loads on the feet.
Flat feet develop more often in people who are used to walking in low-toe shoes on flat surfaces (city asphalt) and much less often in those who find time to periodically walk along rocky paths, grass, and sand barefoot. In women, the problem often arises as a consequence of a significant increase in body weight during pregnancy.
To prevent serious disorders in the functioning of the musculoskeletal system, it is important to respond to the first “bells” as early as possible and contact a specialist who will help you choose the right shoes for flat feet and recommend effective corrective exercises.
How to choose shoes that are safe for health?
The structure of the musculoskeletal system ensures uniform distribution of body weight along the axis of the body and over the entire area of the foot. One of the most important functions in weight distribution is related to the unique anatomy of the foot. It has a complex structure - it has 26 bones, 33 joints, and more than 100 ligaments and tendons are responsible for its work and stability.
Shoes can greatly influence body weight distribution and can be both beneficial and detrimental. In this regard, high-heeled shoes (stiletto heels) and shoes with flat soles raise the most questions.
Of course, the foot is most susceptible to the negative influence of “wrong” shoes, because it does a lot of work to maintain the weight and balance of the body when you stand, walk, run, jump, squat, etc. But the wrong shoes can disrupt the load and for the entire musculoskeletal system. When explaining this phenomenon to patients, I usually give an example of an analogy with a house on stilts: if the angle of the stilt changes, the entire house can warp.
High-heeled shoes lead to excessive stress on the anterior parts of the knee joint, which can cause pain under the patellas (patellofemoral pain syndrome) or cause various diseases of the knee joints associated with pathological stress. High heels cause excessive hip flexion when walking, which increases the risk of developing hip arthrosis as you age. The anterior shift of body weight also leads to some overextension of the lumbar spine, which increases the load on the muscles of the lower back, causing pain in this area and (possibly in the future) progression of “osteochondrosis”.
Shoes with flat soles sharply reduce the ability to unload the arches of the feet, causing them to “sag” under the weight of the body. This leads to a decrease in the shock-absorbing capabilities of the foot, stretching occurs, and great tension on the muscles and fascia of the arch of the foot, which can cause the development of inflammation of the plantar fascia - the so-called plantar fasciitis (better known as a “heel spur”). The Achilles tendons, posterior parts of the ankle joint, calf muscles, muscles of the back of the thigh, and lumbar spine may become inflamed. And of course, this can intensify persistent irregularities in the shape of the foot in the form of an increase in various types of flat feet.
— Is it true that walking in heels is harmful? Why? How many hours a day can you spend in stiletto heels?
— There is no clear criterion, but it is important to know that high-heeled shoes are, in principle, harmful. No matter how beautiful high heels are, they are not suitable for walking or working in an office all day. Yes, it's impressive, but it's not safe. However, ladies who wear stiletto heels are unlikely to notice this right away. After all, many harmful factors can be compensated for over a long time. But gradually, as fatigue increases and compensatory mechanisms decrease, problems can become noticeable and sometimes worsen.
The main reason is that high heels transfer body weight forward to the balls of the toes, which greatly increases the pressure on the muscles and joints of the forefoot. This can cause pain in the feet and lead to changes in their structure such as transverse flatfoot (flattening of the transverse arch of the foot). The consequence of these processes are diseases such as chronic pain syndrome (metatarsalgia), valgus deformity of 1 toe (so-called “bumps”), hammertoe deformity, Morton's neuromas, etc. The higher the heel, the longer the foot is in the wrong position , the greater the likelihood of such changes. Of course, this does not appear immediately, but with age, the ligaments and tendons weaken a little and without additional factors, gravity and body weight change the shape of the foot, the arches gradually “sag,” the feet become wider and “stretch out.” Significant weight fluctuations, such as weight gain during pregnancy, can even increase your foot and therefore shoe size.
— What heel height is safe? What should those who must wear high heels at work do?
— There are many opinions on this matter. The simplest thing is to wear shoes that are comfortable. The safest heels are from 4 to 6 cm, depending on height or leg length. I also came across more accurate calculations of the optimal heel height using the formulas: foot length (in cm) : 7 (for example, 26 cm : 7 = 3.7 cm) or (height (in cm) : leg length (in cm) – 1.61 )*10 (for example (170 cm : 80 cm – 1.61)*10 = 5.15 cm).
But even the optimal heel length increases the load on the forefoot from approximately 22 to 57%, while for some reason many women are more comfortable this way, which has to be admitted, but is difficult for a man, even an orthopedic traumatologist, to understand.
— There is an opinion that flat-soled sneakers are also harmful. Is it so?
— Yes, and not only sneakers. A flat sole provokes the development of flat feet and other diseases such as heel spurs. In addition to the flat sole, some models of sneakers also have a very thin sole, which does not have sufficient shock-absorbing properties; not only the feet, but also the knees can suffer from this.
— What about ballet flats, slates?
- The same as with sneakers, especially if we are talking not about soft, but about leather shoes. Such shoes do not unload the foot and do not have sufficient shock absorption. My opinion is that you need to buy anatomical shoes.
—Then the narrow toes of the shoes are abolished?
- This is a difficult question. Narrow toes can be an extension of a regular shoe last (for example, cowboy boots or Arab shoes), or they can be really narrow shoes. This is definitely harmful because it leads to compression of the forefoot. This causes problems such as ingrown toenails, injuries and deformities of the toenails. Compression of the bones can cause pain in the foot and the development of Morton's neuromas.
— Do I need to choose shoes with arch support? What is its meaning?
— With age, almost everyone understands that shoes with arch support are easier, so they switch to such shoes themselves. I think everyone needs shoes with arch support. The main task of the arch support is to relieve the longitudinal arch of the foot, which reduces the likelihood of pain. It’s just that standard arch supports may not be suitable for everyone. Selecting an instep support is a very complex topic and needs to be discussed separately.
— What shoes should people with flat feet wear?
— Flat feet is a collective term. There are many different types of flat feet, and there are other features of the structure of the foot that affect the choice of shoes or insoles. Accordingly, you first need to determine the type and degree of flat feet. And this is usually done by specialists, using special devices and instruments. There is no standard answer to this question. If a person has flat feet and this causes any complaints, it is best to consult a specialist and choose shoes based on individual characteristics. At a minimum, anatomical shoes with good, albeit standard, arch supports are desirable. Such shoes can be quite elegant, but their price is higher than that of ordinary shoes.
— Everyone likes to wear different shoes, but which one is best for your health?
- Complex issue. Apparently, comfortable anatomical shoes. Personally, I like the definition: “Shoes should be appropriate for your activity.” After all, even the shape and last of sneakers differ depending on the sport...
— It seems that sneakers are the ideal shoes. Is it possible to wear them all the time?
— It’s possible, but not necessary, and you need to pay attention to foot hygiene.
— What shoe size is optimal for foot health? Exactly along the leg or a little more?
— Shoes should follow the anatomy of the foot. Therefore, shoes should not be larger or smaller than the actual size of the foot. The size of sports shoes, for example, should correspond as much as possible to the length of the athlete’s foot. These shoes are comfortable and safe.
Characteristic signs of flat feet
To check how correctly a child’s foot is forming, you can use this home diagnostic method: lubricate the baby’s feet with paint or rich cream and ask him to take a step on a clean sheet of paper. This way you will get a clear imprint of the child's foot and will be able to analyze it for any deformities.
If the characteristic notch at the inner edge of the foot on the print occupies less than half the width or is displayed entirely on the sheet, then you need to contact a specialist as soon as possible to confirm the diagnosis and receive recommendations for correcting the defect.
Attention! Until the age of 3, this diagnostic method does not make sense to use, since children still have an impressive fat pad in the sole area.
In adolescents and adults, flat feet can be suspected if the legs get tired quickly, after physical activity there is pain in the feet, the ankles constantly or periodically swell, there is a feeling that the width and length of the feet have increased.
Which pair to choose at different stages of deformation?
The choice of orthopedic product directly depends on the degree of flat feet. When identifying deformities, orthopedists recommend:
- Stage 1-2 (the first deforming changes, the legs get tired quickly, slight swelling may occur) - suede, nubuck products with orthopedic insoles with a small wide heel, with a tight heel, a round or square toe, lacing to control the density of the transverse girth; special inserts, finger holders; rejection of rigid wedges and platforms;
- Stage 3 (pronounced changes that can be detected even with a cursory visual examination) – constant wearing of orthopedic shoes, the choice of which must be monitored by a specialized specialist.
Women's shoes for flat feet
Flat feet can cause a woman a lot of inconvenience, because following fashion trends and the extremely unhealthy principle “beauty requires sacrifice,” they buy a pair of high heels, which only aggravates problems with the limbs.
When diagnosing a disease, experts recommend at least temporarily abandoning extremely high stiletto heels, but not going to extremes by choosing a product with a flat, inflexible sole. The optimal solution would be to buy medium-height shoes or sandals with heels up to 5 cm. When choosing a model, it is better to choose a pair made of soft leather, suede, nubuck, on the inside of which there are no seams that put additional pressure on problem areas that provoke the development of soft and hard calluses .
You should not ignore the disease at stages 1-2, because it is during this period that you can get by with “little blood” and return your feet to their normal shape. At the last stages, the deformations are already stable and it is almost impossible to correct them.
What is pronation?
When running, your leg joints experience increased stress. When contacting a hard surface, the foot suffers a strong blow, which is transmitted to the knee, hip joint and lower back. At this moment, the natural shock absorption mechanism is activated, which absorbs the force of the impact. At the same time, the foot becomes flatter, and its arch turns inward. This correct placement of the foot during movement is called pronation.
There are hyperpronation, hypopronation and neutral pronation.
Overpronation is characterized by a strong inward displacement of the arch of the foot during movement. In this case, a decrease in the longitudinal arch of the foot is observed. Overpronation often accompanies flat feet. With hypopronation, the arch of the foot moves outward when moving. Both deviations of the foot from the neutral position do not provide adequate shock absorption during movement, which increases the risk of injury. With neutral pronation, the natural shock absorption mechanism works properly.
Men's shoes for flat feet
Flat feet are traditionally even more common in men than in women. You can find a variety of men's orthopedic shoes on sale. When going to the store to choose corrective shoes or boots, we recommend that you be guided by the following criteria:
- flexible sole made of materials with a special structure;
- shoes should provide good fixation and uniform load distribution;
- matching pair to the size and individual characteristics of the foot. Shoes or boots should be moderately loose in length and fullness;
- the presence of special insoles of an anatomically correct shape, providing good shock absorption when walking;
- The choice of models with a wide toe is welcome. This solution helps prevent circulatory problems in the feet.
Special everyday and training shoes for flat feet may not look too different from ordinary ones, but their price, for obvious reasons, can be significantly higher.
Shoes that are too narrow
Narrow shoes squeeze your feet. The forefoot cannot be positioned freely. The thumb and little finger are pressed inward, and the middle fingers are bent. An unnatural position, first of all, provokes the appearance of calluses.
Also, pinched toes do not participate in the smooth roll of the foot from heel to toe. The gait ceases to be easy and the joints suffer - the shock load when walking with pinched fingers is distributed unevenly.
Due to tight shoes, normal blood flow is disrupted. There are prerequisites for numbness, cramps, premature leg fatigue and swelling at the end of the day.
Therefore, shoes that closely follow the natural contours of the foot are preferred.
Children's shoes for flat feet
Has your child been diagnosed with flat feet? In childhood, returning the feet to their normal shape is easier than fighting the disease in adulthood. To choose the right orthopedic shoes, you should first enlist the help of an experienced specialist. For successful correction, you need to bring your baby for preventive examinations to an orthopedist at least once every 3 months.
It is optimal to order corrective shoes in a special salon, where craftsmen will take individual measurements and make the right pair to order. Orthopedic shoes, boots, sandals for children must meet the following criteria:
- heel no more than 2 cm;
- flexible sole;
- laces or Velcro;
- tight back;
- high-quality instep support;
- anatomical insoles;
- breathable upper material.
To get the best results, it is recommended to combine wearing special shoes with doing exercises to strengthen muscles and attending therapeutic massage sessions.
Universal rules
- Size.
The shoe size should be chosen so that the big toe does not reach the toe of the sneaker by at least 3-4 millimeters. What is this connected with? When running, the foot increases in length and width, and if you choose the right size sneakers, running will not bring pleasure, but only injury. For the same reason, it is better to try on sneakers in the evening, when the foot is swollen from daytime activity. For fitting, it is worth bringing your running socks and orthotics with you, if you use them. - The weight of a pair of sneakers.
“Light sneakers are not always good. Lightweight models are suitable for competitions so that the shoes feel as little as possible on the foot. The weight of the sneaker comes from shock-absorbing inserts, fixing elements and other technological solutions. They will help you feel good the day after the race. But a pair should not be heavier than 400 g,” Igor Brykov, shoe selection specialist at the RunLab store. - The sole and upper of the sneaker
must be flexible and soft in the front part. Pay attention to the inserts made of abrasion-resistant rubber; in most cases, they are located in the heel and on the outside of the toe of the sneaker, where the main load falls. - Depreciation.
Most often it is located in the heel, sometimes it is also present in the toe; there is also an option when the shock-absorbing cushion is evenly distributed throughout the sole. All manufacturers of high-quality running shoes indicate exactly where the shock-absorbing inserts are located in the sneakers.
Every six months, global shoe brands release new models, the development of which focuses on shock absorption and manufacturability. For example, the new product of the season from Under Amour is the UA HOVR line of running sneakers, which consists of two models: Sonic and Phantom. Thanks to innovative materials and shock absorption systems, they provide excellent shock absorption and energy return. Therefore, the runner retains a feeling of “zero gravity” regardless of the distance covered. If we talk about the sole as a whole, it is very durable and does not wear out.
Photo: Under Armor
Rigid elements of the upper of the sneaker are allowed only in the heel area. But they should not be in contact with the leg, rubbing or putting pressure on the Achilles tendon. The sneaker must support the foot. If this is running on mountains or a sandy surface, the foot periodically does not stand up straight: if it is poorly secured, it will fall out and the athlete will be injured. When running on asphalt, rigid fixation is not needed, because the asphalt surface is smooth and the movement occurs in a straight line. Moderate support should be felt in the heel and midfoot, otherwise the legs will cramp.
- The lacing
should ideally be located asymmetrically on the sneaker, closer to the inside of the foot. It is better if the lacing loops are not united by a single rigid bar. They should be able to move slightly so that the shoe can fit more tightly on the foot. - Breathable technology.
Running shoes are never made of leather or other poorly breathable materials. Ventilation is especially important for long-distance runners. From the line of new products, we advise you to pay attention to HOVR Sonic. The flat woven upper provides excellent ventilation.
This is interesting!
The proportions of a woman's foot on average differ from the proportions of a man's: a woman's foot is narrower. In addition, it is worth remembering that the average weight of a male runner is 80 kg, and a female runner is 55-60 kg, so a girl may find a male model of running shoes stiff. Girls, if you decide to buy a men's model, choose a low degree of shock absorption and a last that is not too wide.
Children's shoes for the prevention of flat feet
Prevention is easier than treatment - this principle should be followed by parents who want to protect their child from a disease that can be considered one of the most common ailments of modern people.
To avoid problems with the musculoskeletal system, it is important to buy the right children's shoes when the baby is just learning to walk. To begin with, you should get slippers made of soft, breathable material that can be adjusted to your feet (with buckles, Velcro, laces). The sole should bend well.
The maximum height of the heel in childhood should not exceed 1.5-2 cm. This element should be wide, stable, and occupy at least a third of the area of the sole. Buying boots with a wide toe box will prevent deformation of the toes and the appearance of painful calluses. The foot in the shoe should not dangle, moving sideways or backwards.
What shoes should you not wear if you have flat feet?
After confirming the diagnosis of flat feet, you should immediately review your home shoe collection and stop wearing:
- models with rigid soles;
- shoes with wedges, platforms;
- high-heeled shoes;
- tight pairs with a narrow toe.
Today you can easily choose a stylish pair for any season from the collections of special orthopedic shoes. Such shoes, boots, sandals look no worse than ordinary ones, not endowed with orthopedic functions.
The disease should not be ignored in the early stages. Timely treatment and wearing corrective shoes will help to avoid serious consequences that cause such deformities, restore the shape of the foot as soon as possible and enjoy a full life without flat feet!
No flat soles
This recommendation applies to absolutely any shoe. The most “dangerous” are beach-type flip-flops. You should only wear those models whose style additionally supports the foot. Otherwise, the existing deformation will worsen.
The foot should not move to the right or left. Therefore, shoes should always be well laced. The size should be selected so that there is at least one centimeter of space in the sock, allowing the toes to be free.