The arch has a huge role in the normal functioning for the foot. When performing normally, the bones of the mid-foot loosen-up when the foot first hits the surface. This permits the foot to work as a shock absorber and allows the foot to adjust to different terrain surfaces. To be able to propel you forward the mid-foot should relock and help make the foot into a firm lever arm. The correct working of the arch necessitates that all the tendons, muscles and joints of the foot work the way they ought to. Eventually some of these ligaments, tendons and muscles could get stretched and fail in their capability to support the arch. This may bring about a condition called fallen arches. Fallen arches not only causes foot and leg pain but may possibly furthermore put the person at risk for developing osteo-arthritis of the knee, hip and low back.

To be able to compensate for fallen arches the muscles of the lower calf have to work much harder. When these muscles are excessively worked they can be fatigued and achy at the conclusion of the day. Additionally the ligaments across the bottom of the foot become stretched out, producing the agonizing ailment medically known as plantar fasciitis. Fallen arches also causes misalignment of the ankle joint which causes misalignment of the hip, knee and low back. All these joints have got to compensate for the fallen arch and because of this become misaligned and unbalanced. When the knee and hip joints are not balanced, the body mass is not evenly distributed throughout the joint. The cartilage gets overloaded in the areas of the joint that take the vast majority of the load. This consequently leads to the agonizing wear and tear of the joint called osteoarthritis.

Sad to say many folks with fallen arches never realize that they could be vulnerable for getting chronic joint problems. On the other hand, when the condition has been identified, the solution can be fairly straight forward. A professionally engineered customized arch support will keep up the arch, align the ankle joint and balance the weight on the knee, hip and low back. The arch support has to be rigid enough to support the body weight, yet flexible enough to enable for shock absorption. Although the therapy is uncomplicated and most economical many walk around each day in agony possibly at risk for arthritis, not aware that the solution to their difficulty is simple, cost effective and does not require an operation or medications.

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The person with the high arched foot can be a difficult foot type to treat.  Many times patients will come into the office with literally a bag full of orthotics and arch supports they have tried that did not help with the pain.

There are a couple of foot motions of the foot, pronation and supination, which we have to discuss before we can start talking about the problems with the high arch foot.  Pronation is the motion of flattening out of the arch as the foot rotates toward the floor. Pronation is important because it allows the foot to absorb shock. In addition, pronation allows all the bones of the mid-foot to unlock and become like a “bag of bones”.  Being a loose “bag of bones” enables the foot to adapt to uneven surfaces (uphill, downhill, rocky surface, etc.). Supination is the opposite of pronation. In supination the foot rotates up from the floor. Supination re-locks the bones of the mid-foot and transforms the foot into a rigid lever arm to provide an efficient push-off and propel the body forward.

As you might expect, people with a high arch foot have the opposite problem as those that have flat feet.  The people with flat feet are over-pronators.  They do not supinate the foot at the end of the step.  Therefore the people with flat feet are unable to lock the bones of the foot to form a firm efficient lever arm for push-off.  However, people with the high arch foot do not pronate.  The foot remains in a locked supinated position throughout the step.  This causes several problems.  First of all if the person with the high arch foot is unable to pronate their foot, their foot is a poor shock absorber.  Thus the impact of walking and running is not absorbed in the foot it is transmitted back up the leg to cause pain in the knee, hip and low back.  In addition the person with the high arch foot tends to overload the bones on the outside of the foot.  This can lead to pain on the outside of the foot and in extreme cases this can lead to very painful stress fractures of the bones on the outside of the foot.  The person with the high arch foot may also be more prone to ankle sprains particularly if they are athletic.

Why does someone develop a relatively stiff, high arched foot.  The high arch can develop form spasm in the muscles which are responsible for supinating the foot.  If these muscles are tight they do not relax when they are supposed to allow the arch to flatten out and pronate.  Some people are born with their heel bone, the calcaneus, in an upward position.  This causes all the bones of the mid-foot to be in a supinated type of position.  Arthritis of the bones of the mid-foot will also make it difficult for the bones to unlock and thus the foot remains in the supinated, high arch position.

The treatment for someone with a high arch centers around providing shock absorption for the foot and distributing the load away from the outside of the foot.  The key to accomplishing this is to make sure that the arch support actually matches the height of the high arch.  This will allow the inside part of the foot to carry some of the load and absorb some of the impact of walking or running.  If the bones on the outside of the foot are overloaded we will usually add some cushioning on the arch support.  For some people we also add a slight wedge on the outside edge of the arch support to prevent the ankle from rolling over, externally rotating, to prevent ankle sprains.

The problems associated with the high arch foot are much different than the problems associated with flat feet.  This is one reason why an off-the-shelf arch supports seldom help the person with the high arch.  The person with the high arch needs a custom arch support made from an accurate impression of the foot.

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Here are some of the problems caused by flat feet:

• Heel pain (worse in the am or when getting up after sitting a while)
• Calf fatigue and ache at  the end of the day
• Shin splints

In order to understand why flat feet cause problems we have to understand a little bit about the way a normal foot functions.  In the normal foot the heel first hits the ground on the back outside corner of the heel.  Then as the foot is lowered to the ground the foot under goes a motion known as pronation.  Pronation is the motion of flattening out of the arch as the foot rotates toward the floor (externally rotates).  Pronation allows all the bones of the mid-foot to unlock and become like a “bag of bones”.  Being a loose “bag of bones” enables the foot to adapt to uneven surfaces (uphill, downhill, rocky surface, etc.). Pronation is also important because it allows the foot to absorb shock.

Further along in the step the foot undergoes a motion known as supination. Supination is the opposite of pronation. In supination the foot rotates up from the floor. Supination re-locks the bones of the mid-foot and transforms the foot into a rigid lever arm to provide an efficient push-off and propel the body forward.

The problem with flat feet is that the foot remains pronated throughout the step.  The problem of flat feet is therefore refferred to in medical terms as hyperpronation.  The foot does not supinate as the foot moves into the later stages of the step.  If the foot cannot supinate it remains essentially a loose “bag of bones” and you are unable to use the foot as an efficient, firm lever arm for push off the floor and propel you forward.

Hyperpronation can cause the heel pain known as plantar fasciitis. The typical symptom of plantar fasciitis is severe heel pain when taking the first few steps in the morning or during the first few steps after sitting for a few minutes.  Hyperpronation causes excessive flattening of the arch.  This causes the ligament called the plantar fascia on the bottom of the foot to stretch out too much.  The excessive pulling on the plantar fascia causes inflammation where the plantar fascia inserts into the heel.

If the foot does not supinate it cannot form an efficient lever arm.  As a result, the calf muscles have to work all that much harder in order to propel the body forward. This causes fatigue and ache in the muscles of the lower legs at the end of the day. In addition if the calf muscles are working harder they become very strong and bulky.

Strong and bulky calf muscles can lead to a condition known as shin splints. The term “shin splints” usually refers to pain along the inside-front part of the lower leg. Shin splints is usually caused by an imbalance between the calf muscles on the back of the lower leg (posterior muscles) and the anterior muscles or muscles on the front part of the lower leg. The more powerful posterior muscles overwork the less powerful anterior muscles as the anterior muscles try to decelerate the body at heel strike. This causes excess strain, inflammation and pain where the anterior muscles attach to the shin bone.

In conclusion, someone with flat feet has very inefficient foot function and this can lead to heel pain, muscle fatigue and shin splints. By adding an arch support, the foot is prevented from hyperpronating and this improves the over-all efficiency of the foot function.  Occasionally you can buy an arch support off-the-shelf that provides support.  However, in most cases, the off-the-shelf insoles only provide cushioning and do not correct the hyper-pronation.  Life is too short to suffer in pain, especially when the problem can be easily corrected.

If someone is having pain as the result of flat-feet it makes sense to spend the extra money to purchase a custom arch support that will correct the problem once and for all.

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