Unlike inanimate objects like a table, where passive support (table leg) is perfectly fine, the human body operates much differently. Orthotics for flat feet… are they all they’re cracked up to be? Internally rotated femur, externally rotated tibia, knee cap off alignment, tibia bowed, ankle pronation and collapsed foot arch. As a result the lower tibia has to rotate/bend inwards resulting in a collapsing of the ankle and foot arch. As we still need to keep our feet underneath our hips when we walk the lower leg will literally bend, this is a bone malformation that takes a long time to occur. For example very commonly if a person's pelvis is oriented towards tilting forward we tend to see the lower leg externally rotate relative to the upper leg, creating a torsion between upper and lower leg, pulling the kneecap to the outside. Oftentimes flat feet are a compensation for something up the chain being stuck in a certain range of motion. To zoom in too much into the local area and treat only that, (i.e passive foot arch support) is ignoring a whole slew of other potential and in all likelihood, direct causes. At Functional Patterns we tend to take a macroscopic view of the issue, meaning that we need to zoom out and look at the body as a whole. We have seen a direct cause of flat feet in the foot through the hypermobile subtalar joint but it really is a chicken egg scenario as to what caused what. Remove the keystone and the structure falls We can look at this cause as direct and local. When this bone is hypermobile it tends to shift forward when a person places weight on their heel which then causes the mid foot to unlock, effectively flattening the arch. If you think of the foot like a stone bridge then the Talis represents the central stone, if we pluck out this central stone the bridge will collapse. In flat feet the Talus bone is often hypermobile. The causes are wide ranging, genetics certainly play a big role as some people are born with the arch bones dropped and never develop an arch. Flat feet, otherwise known as duck feet, are feet that have a dropped arch, the degree of which varies but in extreme cases there is zero arch and the foot effectively resembles a paddle.
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