According to a study out of India that surveyed 2300 children there is no correlation between sandals or bare feet and flat feet. On the contrary sandals and bare feet actually prevent flat feet or fallen arch, by making the intrinsic muscles of the foot work, thus strengthening the arch indirectly. Closed toed shoes can be attributed to the weakening of these muscles and predisposes a person to flat feet. These are some of the things that can be done to alleviate the effects of the complex. Anyone who has issues with their feet should immediately visit a specialist in order to ask for treatment or advice about their problem. You can sometimes identify overpronation in a person with flat feet by observing them from behind. You may see something called the "too-many-toes" sign, where the individual's toes and forefeet splay outward. Tarsal Coalitions - Tarsal coalitions are congenitally fused foot bones that cause a rigid flat foot often associated with painful muscle spasms. This type of flat foot is usually diagnosed later in childhood or in adulthood. Casting is a method used for children whose flat feet are caused by bone positional abnormalities, such as metatarsus adductus. It involves using a series of casts to assist in re-aligning leg and foot bones to their proper anatomical position. The management of these coalitions is still controversial. However, patients with persistent symptoms who do not have degenerative changes have the option of continued conservative care, resection of the coalition or arthrodesis. Resection is likely to fail if coalitions exceed 50% of the middle facet of the subtalar joint. Non-operative treatment is rarely successful and with serial casting there is a danger of increasing the heel valgus 10 . Surgical stabilization of the hind foot with heel cord lengthening and realignment of the bones of the forefoot are necessary 11 . Most of the time, fallen arches do not require treatment. If your child has flexible flatfoot and experiences pain, his doctor might recommend an arch support to relieve the discomfort. When a short Achilles tendon causes flatfoot, stretching exercises may be needed, according to Seattle Children's Hospital. Rarely, a child may need surgery to lengthen the tendon. A child with rigid flatfoot that causes pain may require shoe inserts, foot wrapping or surgery. Considerations In order to diagnose flat feet your doctor will conduct a visual examination. In people with flat feet, the instep of the foot usually comes into contact with the ground when standing flat-footed. The choice of shoes can make a significant difference in the comfort of someone with flat feet. In general, a supportive shoe needs to provide just that- support. The following characteristics make a shoe more supportive for those with flat feet. Keep in mind that to best support a flat foot, the shoe itself should rest flat on the ground. Heels are inappropriate for both flat feet and high arches. Shoes with raised insoles – There are various shoes that have raised insoles that build an artificial foot rest. Higher insoles provide support to the middle-foot which proves to be beneficial for flat feet. Find out more Articulated AFOs were used in cases where the valgus present could be controlled with a minimal amount of surface area contact medially with a well-molded medial longitudinal arch support and where the hindfoot exhibited no pathological related rigidity. The ankle was free motion unless the physician anticipated the development of an equinus contracture. If this was the case, a 90º plantarflexion stop was included. Padding the medial aspect of the orthosis will not only increase comfort but also allow for a soft and flexible correction, provided the positive model was modified accordingly. Insufficient modification will cause discomfort as the ankle is wedged medially/laterally within the orthosis. Pes Cavus is caused by muscle imbalances in the lower leg and foot that draws the front of the foot, or sometimes draws the heel downward, making the arch higher than normal. It usually begins during childhood and may be associated with neurological conditions such as muscular dystrophy or spina bifida, but not always. In many cases the muscles of the feet become tighter or weaker for unknown reasons. As with many medical conditions, genetics play a role in who will become afflicted with high arches. These shoes offer extra support for the foot whether there are problems or not. Anyone who wants to protect their feet can use them. Whether experiencing pain or not, the general public and many of patients are quite concerned about their flatfeet. As if the flatfoot is a ticking time bomb that will ruin their life, everyone wants to know what they can do for their flat feet! There is truth to when your feet hurt your whole body hurts, but often, the trick to keep your feet happy is not taking them under the knife. With that said, there are a considerable number of people who benefit greatly from surgical reconstruction of their foot. These people have exhausted all conservative treatments that have all failed to bring them relief. This finding examines the strength and ease of movement the athlete or patient displays during the various movements assessed. It is seen during low load testing as the depth the individual is able to achieve for example during the squat, lunge, and single leg squats. During high load conditions it is the individuals’ ability to absorb forces through the muscular system and to develop power (rate of force development) Rotation is very similar to the finding of lateral shift and is often found in conjunction with it. Rotation may also represent a favoured motor pattern that can indicate the presence of weak and tight neck muscles.