Have you been dreaming of enrolling in the military? Have you spent days and weeks on end imagining yourself flying the aircraft of your country’s Air Force or aboard a ship of the Navy?
Now, you are afraid that one factor is about to stand between you and your dreams – flat feet.
Maybe you are already in the military and you just noticed that this condition is developing on one of your feet or the both of them. Are you worried if it might be a reason for a disqualification?
Although this is widely argued, flat feet can actually get you disqualified from the military. But it varies from country to country and depends on what type of flat feet one possesses.
One may ask, why are flat feet bad for the military? Let’s find out.
How Can You Find Out If You Have Flat Feet?
There are two main ways you can find out if you have flat feet by yourself. They are:
Wet your feet and stand on a smooth flat surface. If the full outline of the feet shows, without any thin part between the balls of the heel and the feet, then you probably have flat feet.
Check the soles of your old or frequently worn shoes. If there is more wear on the inner side of your heels than the outer part, you might have flat feet. The shoes might also lean inward, taking the shape of the rolled in feet.
Why Do Flat Feet Disqualify You from The Military?
There a lot of reasons that make the military consider flat feet as hard DQ. Recruits go through rigorous physical training such as walking, climbing, marching and running, and they also travel long distances on foot.
This might become a problem for someone who has flat feet that are accompanied by pain.
The ligaments and tendons of the feet tend to weaken in flat feet over time. This weakness sometimes leads to the collapse of the arch and pains in the feet, ankle, knee, hip and lower back.
This pain usually caused by the inability of the feet to successfully distribute the body weight and absorb shock.
This pain and weak tendons can affect one’s ability to serve in the military efficiently.
Even though orthotic insoles might be used to manage this condition, it is a liability to the military and incurs extra expenses for disability claims.
Standing on flat feet for too long might cause pains and discomfort and this might make the person unfit to carry out discipline training that involves standing.
Can You Join the Military If You Are Flat-Footed?
The answer is yes. It depends on the country and if the flat feet are symptomatic or asymptomatic.
Symptomatic flat feet (SFF) is a condition where the flat feet are accompanied by pains and are linked to other conditions such as arch pain, shin splints, plantar fasciitis and change in gait during physical activities. Asymptomatic flat feet (AFF) show no symptoms.
In the USA currently, the symptomatic flat feet are a disqualifying condition that cannot be waived.
People with asymptomatic flatfeet are not disqualified unless they show signs of pain or change in gait while running or marching.
If there is no pain associated with the flat feet because the person is using prescribed orthotic insoles, there is a chance of disqualification since this means that there is a chance of developing pains on the flat feet in the long run and after rigorous training.
This is because soldiers are always on their feet and sometimes need to run or walk long distances. It is also a measure to reduce the number of people who will eventually apply for disability compensations in the long run.
A flat foot is a condition that occurs when the foot arch becomes too low that they fully touch the ground when standing. The foot normally flattens when it carries the body weight in the standing position, but the flat foot does not retain the arch.
Flat foot is usually associated with pains on the foot, the ankle, and back. This is because the bodyweight is borne poorly by the flat foot and therefore transfer the shock to the ankles, legs, and hips.
A flat foot is not as capable as the normal foot in maintaining the stability of the body. As a result, the flat foot stands a higher chance of muscle strain since the muscles of other parts of the body recompense for the inability of the flat foot to help the body to be stable.
Also, the flat foot does not allow the body to maintain a proper standing posture. When the arch of the flat foot falls, the legs roll inwards thereby putting pressure on the heels and ankles. This, in turn, affects the legs, hip, and back.
Are Flat Feet Good for Anything?
The mindset towards flat feet is changing and the advantages of flat feet over other feet types are now being taken note of.
Studies found out that high-arched feet are more prone to injury than flat feet due to its very poor shock-absorbing ability.
There is also this assertion that flat feet might give an advantage to athletes.
The flat feet roll in when standing and walking. This rolling in helps the feet to absorb shock and protect it against injuries.
High arched feet rest on the heels and balls of the feet and do not absorb shock so well. The impact of the physical activities is sent back to the knees, back and hips.
How Can Flat Feet Be Treated?
The treatment of fallen and high arches depends on how severe it is and the root cause of it. If no pain or discomfort is felt, no treatment is necessary. These treatments can be used to manage and probably correct pes planus:
Flat feet (also known as fallen arches or pes planus) is a physiological disorder that occurs when the arch that is present in the foot flattens or collapses and is partially or completely touching the floor.
It might be present at birth or can be developed over time. Flat feet can be detected by visual tests, by x-ray and CT imaging.
If the pain is felt on the feet after long periods of standing, flat feet might be the cause. Sometimes it can be accompanied by back, knee and hip aches.
Watch a video on this topic below:
Flat feet in children are caused by abnormal joint formations and baby fat that is stuck between the bones.
They are usually flexible because they appear normal until the child stands and the feet bears weight. This flexible flat foot can become normal and becomes rigid as the child grows.
Adult flat feet are usually rigid and permanent and are caused by illnesses, injuries, accidents, high heel shoes, and autoimmune diseases.
Most times, flat feet do not cause pain or any symptoms, therefore it does not require treatment. If pain exists, some of these treatment options can be used:
This shoe offers great comfort, cushioning, heel stability, removable footbed, and a wide toe box to enable forefoot flexibility.
The sole is made from rubber that provides superb cushioning, and the footbed is made from latex foam. It has a full-grained leather upper, with a moisture-absorbing mesh lining that makes the shoe breathable.
The interior is fully padded, and the EVA midsole provides great shock absorption and durability.
It is made from 100% synthetic material and possesses and orthotic footbed that provides maximum support for overpronated and supinated feet. It is slim, soft, lightweight and is perfect for walking long distances.
The fabrics used in the design of this shoe is stretchy to enable easy and fast movements. It also possesses a flexible and breathable EVA sole and a removable orthotic insole for total comfort and support for achy feet.
This shoe can pass as a casual shoe and as a dress shoe too. The rubber soles provide traction and comfort in every step. It can also be used as a working shoe.
It is designed with premium leather and a synthetic sole. The footbed is removable to accommodate prescription insoles. It is ultra-lightweight, possesses smooth lining fabrics and soft paddings for optimum cushioning.
These lightweight 3D grid-pattern knitted shoes are designed to fit snugly on the foot like a sock and provide comfort during movement. The ultra-light synthetic outsole feels like a feather on the feet.
It is suitable for activities like walking, jogging and running and the knitted upper is breathable and will keep the feet cool during physical activities.
The tongue possesses an integrated collar that is low cut to take up the shape of the feet to provide all-day comfort.
Factors to Consider While Choosing Running Shoes for Flat Feet
It is sometimes overwhelming to find the right shoes for walking, training and other physical activities. There are a lot of factors you could consider before buying shoes.
Comfort is an important factor to consider while choosing shoes to help in the management and treatment of flat feet.
The shoes should be soft and provide enough cushioning when the foot hits the ground. It should also have soles that offer adequate arch support are not rigid.
Also, the shoe should have a wide toe box and a heel that is not floppy so that it will help the feet to properly distribute the force exerted on it by the bodyweight during physical activities.
Ensure to try out shoes first before buying them and in the presence of a shoe expert. Always buy shoes in the morning or midday before the feet get swollen from daily activities. Always make sure that the shoe can be returned if they are uncomfortable and do not properly fit.
This is simply the way the body moves when steps are taken. The gait is determined through a walking test and differs from individual to individual. The gait can be normal or abnormal.
Abnormal gait can be a result of an accident, injury, illness, bone deformation or muscle disorders. Flat feet can also cause abnormal gait especially if overpronation or supination is present.
When choosing a shoe for flat feet, gait should also be considered. If the flat feet cause the feet to move inwards, shoes that offer great arch support should be chosen.
Likewise, if the feet supinate, a shoe that has a superb cushioning should be chosen since ankle pain could be a great issue.
VIDEO: Normal Gait and Common Gait Abnormalities
This video explains the different types of gaits. it also differentiates the normal gait from the abnormal gaits.
The structure and shape of flat feet are somehow different from that of normal feet. Flat feet are wider than arched feet and hence covers more space in a shoe.
It is therefore very important to choose wide shoes that will not squeeze the feet together and cause discomfort.
The proper shoes for flat feet should not have an hourglass shape like the shoes meant for arched feet. They should be straight and wide enough to accommodate the feet comfortably.
Motion-control shoes used in the treatment and support of flat feet should be made with durable and strong materials.
It is targeted to help in the correction of muscular movements and as such should not be too flexible else it can’t achieve that purpose.
It should be strong enough to bear the forces exerted to the feet by the body and at the same time preventing the feet from moving in its original manner.
The shoe should be made with durable polyurethane materials, especially at the soles and arch support system.
Foam materials are also reputable for its strength, durability and superb cushioning effect. It is also advisable to look out for shoes produced with foam materials.
This is the style that the shoe producer integrated into the shoe, putting into consideration a lot of purposes the shoe is meant for.
Some of the design attributes that are put into consideration in the choice of flat feet shoes are:
Rigidity at the sides
Foam of dual-density in the soles for a proper rebound
A specific flat feet surgery or a combination of surgeries can be done to correct the fallen arches. Some of the procedures are used to correct bone deformities and some are used to repair inflamed ligaments and tendons.
It is the duty of the foot and ankle surgeon to decide the best procedure(s) to tackle the cause of the flat feet as shown in the test results.
Although flatfoot surgery can be done under general anesthesia, regional anesthesia is used more often. This is the process of blocking the spine or nerves of the foot and ankle to reduce pain during the surgical process.
One or more of the following types of surgeries can be used to treat fallen arches and rigid flat feet.
Lateral Column Lengthening
This is a procedure that is used to correct flat feet disorder where the forefoot is extending to one side. Most times, this surgery is done together with calcaneal osteotomy. The lateral column lengthening surgery can reshape feet completely.
It has been used to efficiently correct totally deformed feet, but it also has a disadvantage of forming a stiff foot which might cause further complications like pains, nonunion (bone healing delay), and nerve damage.
The lateral column of the feet is:
The fourth metatarsals
The fifth metatarsals.
They are joined to each other in this order and extends from the heel to the midfoot. The lateral column lengthening surgery involves the insertion of a bone graft to extend the length of the column.
The bone graft to be used can be obtained from the pelvis of a cadaver and should be about 7-10mm in length and have a trapezoid shape.
Lateral column lengthening can be carried out in two ways:
The calcaneus can be cut from the front, just before its joint with the cuboid. Then it is shifted about 7-9mm apart to accommodate the bone graft.
The joint of the calcaneus bone and cuboid bone can be separated and moved apart to allow the insertion of the bone graft between it.
After the bone insertion, the bone graft which is used to extend the lateral column is held in place, with a metal plate or screws.
Calcaneal osteotomy is a procedure used in correcting bone deformities just like the lateral column lengthening procedure.
The calcaneal is one of the bones of the feet located near the heel. Osteotomy is a surgical process of cutting a bone. The calcaneal osteotomy is done to realign the heel bone and place it directly under the tibia (shin bone).
When the procedure is done to shift the heel bone towards the inner ankle, it is known as a medializing calcaneal osteotomy. When it is done to shift the heel bone towards the outer ankle, it is known as a lateralizing calcaneal osteotomy.
The heel of the flat feet (pes planus) is shifted a bit far to the outer ankle. The heel of the high arched feet (Pes Cavus) is shifted far towards the inner ankle.
The medializing calcaneal osteotomy (bone shift towards the inner ankle) is therefore used to correct flat feet while lateralizing calcaneal osteotomy (bone shift towards the outer ankle) is used to correct high arched feet.
A cut is made near the heel bone, the bone is shifted and held in place using screws.
This is best suited in the correction of hindfoot deformity that is accompanied by joint stiffness and arthritis.
Although it is the most efficient procedure, it is not often done unless the joints involved are severely deformed or damaged and can no longer be preserved.
This involves the joining of 3 joints to form one joint. The three joints joined in triple arthrodesis are
The Subtalar Joint
This is also known as the talocalcaneal joint which is positioned directly under the ankle joint. It is a joint of the calcaneus bone and the talus bone.
The Talonavicular Joint
This is a joint of the talus bone and lower half of the ankle joint and the navicular bone. This joint is responsible for the circular movement of the foot.
The Calcaneal-cuboid Joint
This is a joint formed by the calcaneus bone and the cuboid bone. The joint involves the distal surface (front) of the calcaneus and the proximal surface (back) of the cuboid bone.
To perform this surgery, two cuts are made on the foot. The inner cut is made to show the inner part talonavicular joint.
The other cut is made on the outer part of the foot to expose the calcaneal-cuboid joint, the subtalar joint, and the outer part of the talonavicular joint.
All the cartilages on the exposed joints are removed and filled with a bone graft. The bone graft can be obtained from the pelvic bone (iliac crest) or tibia of a cadaver.
The hindfoot is then realigned and the joints are joined with wires. They are all held in place using screws or a metal plate.
This is used mainly to treat the posterior tibial tendon dysfunction. This is a condition where the tendon of the tibia (shin bone) is overstretched or has damaged. This usually occurs in people with flat feet.
This surgery is done to transfer the Flexor Digitorum Longus (FDL) tendon to the position of the posterior tibial tendon. The FDL tendon is responsible for the ability of the 2nd, 3rd, 4th, and 5th toes to curl.
This surgery is done by making a cut from the inside of the ankle joint all the way to the midfoot.
The cut continues until the posterior tibial tendon and the FDL tendon are exposed. The tendon transfer can be carried out in either of these two ways:
The Flexor Digitorum Longus (FDL) tendon is wrapped around the posterior tibial tendon and they are stitched together
The FDL can be fixed directly on the bone where the posterior tibial tendon is originally inserted using a screw or with stitches.
This is often carried out together with lateral column lengthening and medializing calcaneal osteotomy to ease the load and stretching of the tendons. If this is not done, the transferred tendon might fail as time passes.
This is also known as Medial cuneiform dorsal opening wedge Osteotomy which is a procedure used to create an arch in flat feet. It is used to treat flat feet caused by posterior tibial tendon dysfunction.
The surgery is done to insert a bone wedge above the medial cuneiform and thus push it down. The joint is fused and held in place with a screw or a metal plate.
Flat feet surgery is usually the last resort in the treatment of rigid flat feet which is causing severe pain and discomfort.
The surgeon may recommend other methods of managing flat feet first before considering feet reconstruction.
The methods that can be used to manage and correct flatfoot deformity are orthotic insoles, arch support cushions, physical therapy, and even weight loss.
How to Prepare For Flat Feet Surgery
Preparing mentally and physically for surgery is very important. This will help you to know what to expect from the process and detect if the surgery is successful or not.
It will also help you to do all that is needed to ensure a successful surgery and quick recovery.
It is a good idea to list your questions, medical conditions, supplements and medications with their dosages.
It is also advisable to attend lessons on how to use assistive devices. This will help to make the recovery process faster and less traumatic.
Certain drugs are not to be taken prior to surgery. Seek medical advice on the drugs and food to avoid while preparing for the surgery. The surgeon may ask you to avoid the following:
Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and supplements like Omega-3 and St. John’s Wort. They are known to increase blood flow during surgery and decrease the rate of bone healing.
Contraceptives should be avoided after the surgery since it is known to increase the risk of developing blood clots.
Metformin and other diabetic drugs that contain or act like metformin should be avoided at least a day before the surgery. These drugs are known to increase the risk of reacting to general anesthesia.
Nicotine found in tobacco and cigarettes should be avoided because it can reduce the blood from the feet. It can also increase the risk of developing infections after the surgical process.
Food and drinks (even water) should be avoided entirely at least 6 hours before surgery. This is because the presence of food or water in your intestines increases the risk of nausea and vomiting when the anesthesia is given.
Flat feet reconstruction surgery is usually done in a hospital with the use of general or regional anesthesia. The purpose of the surgery might differ and so is the procedure. However, each of the surgery follows basically the same process but the recovery time may also vary.
The purpose of feet surgery may be to realign the feet, remove inflamed tissues or muscles or tendons, and to create feet arches.
When the surgery is performed, the surgeon makes some incisions and remove the inflamed tendon while replacing it with another tendon.
The surgeon may also make a cut, realign the heel bone and hold it in place with a screw. Some other procedures might be taken depending on the cause of the flat feet and the source of the flat feet pain.
After the surgery, the patient is wheeled to another room for close monitoring and recovery. Some patients might be allowed to go home from the hospital the same day or to sleep overnight if need be.
VIDEO: Flat Feet Reconstructive Surgery
This video shows how the feet looked like before and after the flat feet reconstructive surgery.
Recovery from Flat Feet Reconstruction Surgery
After surgery, a cast will be put on the feet, painkillers might be given and a schedule for another appointment will be fixed.
To avoid swelling, always place the foot on an elevated surface and avoid placing the bodyweight on it for at least two weeks.
Walk around only when necessary, avoid smoking, hard drugs, and anti-inflammatory drugs because they might delay bone fusion and eventual healing. If the quantity of bloodstains in the plaster cast becomes copious, talk to your doctor.
Keep the cast totally dry. Cover it with a waterproof material before you take a shower. When the wound is healed and the cast is removed, you can shower without covering the wound.
When the cast is eventually removed, talk to your physiotherapist on how to massage the area to facilitate total healing. The wound scabs will fall off by them without your assistance and you should talk to your doctor if the wound becomes reddish or swollen.
The physiotherapist should also assist in walking lessons, gait correction, and muscle rehabilitation. Walking would be painless and easier after twelve weeks, with minimal swelling. Normal daily and even sports activities might be possible after six months.
The metal used in the surgery for the fusion of the joints might become conspicuous and make the feet appear deformed. If this occurs, the metal plate can be removed after the foot heals.
The pain and the deformities that led to the surgery might still be present after the surgery. It is important to talk to the doctor if you don’t see any changes or feel relief after the surgical procedures. Orthotics might be recommended to assist in the correction of the problem on a long-term basis.
The nerves near the incision site may be damaged and become numb. It is usually a normal occurrence in surgeries, but the doctor should be notified in case it is due to inflammation or an infection.
Blood clots might start to form in the deep veins of the feet. This is also known as Deep Vein Thrombosis (DVT).It is usually characterized by pain, redness, swelling, warmth, and discoloration of the skin of the affected area.
Flat feet (also known as pes planus or fallen arches) is a condition whereby the entire soles of the feet touch the ground when in a standing position.
Under the foot is an upward curve called an arch. The longitudinal arch runs through the length of the foot while the transverse arch runs across the foot. The arch is held up by the attachment of the muscles to the bones by the tendons.
A lot of factors can lead to fallen feet. Some of them are environmental while some are genetic. Flat feet due to genetics can last for a lifetime while flat feet due to environmental factors can occur towards old age.
Some causes of flat feet are genetics, injuries like torn tendons, rheumatoid arthritis, obesity, diabetes, pregnancy, high blood pressure, and old age.
When the soft tissue supporting the arch gets weaker it tends to fall, and this is known as posterior tibial tendon dysfunction.
Causes of Flat Feet
There are different causes of flat feet. Some are congenital (present at birth) while some are acquired. Some of the common causes of flat feet are
This is a process of transferring traits from one generation to the next. Studies have shown that genetics can play a very significant role in the development of flat feet. At birth, defects like vertical talus might be present and it leads to rigid flat feet.
Later in childhood, other feet defects like the tarsal coalition might be detected and can also lead to flat feet.
This is a deformity of the foot and it is rare. It is congenital (present at birth) and it can occur on one foot or on both feet.
It is usually painless for the baby, but it can lead to discomfort or disability as the baby gets older.
The talus is a tiny bone that is positioned between the calcaneus (heel bone) and the two major bones of the leg, the fibula, and tibia. The talus connects the foot with the legs and helps in bearing the weight of the body.
In congenital vertical talus, the bone forms in a wrong position and other bones that are normally in front of the talus shifts above it.
As a result of this, the foot will point upwards and the bottom of the foot becomes stiff. Most times, the arch of the foot curves outwards in a condition known as overpronation.
There are 7 bones that make up the tarsals (mid and hindfoot). They help in movement and the bearing of the body weight. These bones are the talus, cuboid, navicular, calcaneus, middle cuneiform, medial cuneiform, and lateral cuneiform.
These bones form flexible joints, but a tarsal coalition occurs when a fibrous tissue or bone cartilage grows on these joints and they stiffen.
This rigidity causes a lot of pain and discomfort and might reduce movement or prevent movement completely.
There are two types of tarsal coalition. They are the calcaneonavicular coalition (CN bar) and the talocalcaneal coalition (TC bar).
The calcaneonavicular coalition occurs when the fibrous tissue or cartilage grows between the calcaneus and talus bone.
The talocalcaneal coalition occurs when the growth occurs between the talus and calcaneus bone.
Tarsal coalition can occur on a foot or both feet. The cause of the tarsal coalition is believed to be a genetic error during the division of the embryonic cells responsible for the formation of the tarsals.
Posterior Tibial Tendon Dysfunction
A muscle is attached to a bone by tendons. The posterior tendons attach the calf muscles to the bones of the hindfoot.
Posterior tibial tendon dysfunction occurs when the tendon that holds the posterior tibial muscles to the feet bones becomes inflamed or torn. This condition also occurs when the joints and ligaments on the inner foot collapse.
The posterior tibial tendon is one of the most useful foot tendons. It helps to hold up the arch and support the foot during movements.
Posterior tibial tendon dysfunction is characterized by pain on the ankles and heels, difficulty in walking, malalignment of the bones and eventual deformity.
This is an autoimmune disease that occurs when the immune mistakenly starts to attack the body tissues. This disease does not only cause inflammation of the joints, but can also affect the heart, lungs, eyes, skin, and even blood vessels.
Rheumatoid arthritis causes a painful swelling that results in bone erosion and eventual deformity.
Cartilages (elastic semi-hard tissue that pad the joints) protects the joints from friction with each other. Rheumatic arthritis breaks down the cartilages slowly and increases the friction between the joints.
This friction leads to inflammation of the joints and damage of the tissues surrounding the joints. This makes the joint weak and unable to bear the body weight properly.
The parts of the body commonly affected by rheumatoid arthritis are the heel, the midfoot, the toes, and the bones below the ankle.
This is a group of disorders, present at birth, that affects the ability to move, balance and maintain a posture.
Foot deformities are associated with cerebral palsy. The most common types of foot deformities that occur in this condition are Pes Planovalgus (flat feet), Equinovarus (club foot), Pes Cavus (high arch), Equinovalgus (plantarflexed feet), and Hallux valgus (bunion toes).
Disadvantages of Flat Feet
The problems associated with flat feet are:
Poor Shock Absorption
The lowering of the arch during movement absorbs the shock exerted on the foot by the body weight. Fallen arches or flat feet do not absorb shock rather the force generated by the impact of the body is transferred to the back and hips.
This leads to the pain on the ankles, knees, hips and back.
This is the inflammation of the plantar fascia which is the thick tissue under the foot that joins the heel bones to the toes.
Symptoms of plantar fasciitis are heel pain, foot tingling, pain after prolonged rest, and heel tenderness,
Diagnosis of Flat Feet
Finding out if one has flat feet can be done personally unless investigations are required to find out the cause. There are two broad tests that can be conducted to find out if one has flat feet. They are by visual tests or by imaging tests.
These tests are performed by visual observations and do not require any equipment. Some of them are
i. Shoe inspection which will be used to determine if the feet are faulty and tend to lean towards the inner parts of the feet. The wear on the heel area of the shoe will determine if the person has flat feet.
ii. Wet footprint exam is done to find out if the arch is high or fallen. The procedure involves the wetting of the feet and standing on a flat surface. If the footprints between the balls of the feet and the heels are showing completely, the feet are considered flat.
iii. Tiptoe tests are done to determine if a flat foot is rigid or flexible. A flexible flat foot shows an arch when on tiptoe while a rigid flat foot does not show a distinct arch.
This is carried out if the cause of the flat feet needs to be discovered or if the flat feet cause pain, discomfort, and disability to a person. The imaging tests often carried out are:
These are tests carried out by using electromagnetic waves and film to capture the images of bones, tissues, and organs.
The electromagnetic rays also known as x-rays are passed through the body onto a film and a white negative image of inner solid structures of the body is shown.
The thicker a body part is, the smaller the amount of x-ray that passes through it and the whiter it appears on the film.
X-rays are avoided during pregnancy since the dose of the electromagnetic waves might be too high for a fetus and can cause defects.
Computed Tomography (CT)
This is also known as a CAT scan and is used to capture a more detailed image of the body than the conventional x-ray scan.
It is a short and painless procedure in which a computer and x-rays create cross-sectional and 2-dimensional images of the bones, organs, and tissues.
The CAT scanner is shaped like a doughnut and it goes around the body part to be scanned. A series of images from various angles are captured. The images are shown as slices of the body structures in a computer and are merged to show a complete image of the part of the body.
This is also known as sonography and is the use of sound waves of high frequency to produce images of inner body parts.
A gel is placed on the area to be scanned and the transducer is used to apply the sound waves and collect the waves that bounced back. These waves are interpreted by a computer into 3-dimensional movements and images of the internal body system.
Magnetic Resonance Imaging (MRI)
The MRI scan creates cross-sectional images of the organs, bones and blood vessels using radio waves, a powerful magnet and a computer.
The MRI scanner looks like a wide tube that a person can slide in, lying on a flat surface. Unlike the X-ray and the CAT scan, the MRI does not use radiation.
Shoe inserts are made to tackle problems for a specific area of the foot and not to affect other parts.
Inserts like heel lifts are made to lift to heel and reduce ankle pain, metatarsal pads are placed behind the ball of the foot for pain relief and heel cups tackle heel pain by absorbing shock on the heel.
Shoe insoles, on the other hand, covers the length of the shoe. They can be flexible or rigid and used to support the foot or the arch.
Orthotics are made on-demand for each foot and are prescribed by a specialist depending on the purpose of use. They are made from a 3-dimensional mold of the user’s foot which can be obtained from an optical scanner, plastic mold or a flexible foam mold.
Just as glasses correct poor vision, custom orthotics correct specific foot disorders by reducing stress and redirecting gait patterns.
They fit into a shoe but unlike an insole, they are made with an exact imprint of the user’s foot.
The longer and more frequent a custom orthotic are worn, the better. The insoles that are bought with shoes should be removed and replaced with the custom orthotic for better results.
They are made from soft and flexible materials to cushion and relieve pain and pressure from a painful part of the foot. Some correct foot abnormalities and treat painful callouses, foot ulcerations due to diabetes, and sore bones.
They can be made with materials like leather, plastic foams, rubber, and cork materials.
They are made with either plastic (flexible or rigid) and graphite materials and can be used to correct abnormalities and accommodate pains on the foot.
They are thinner than other types of orthotics and fit easily into shoes.
They are mostly used to manage or treat and ankle pain, heel pain, arch pain, big toe pain, toe joint pain, ankle tendonitis, bursitis, and shin splints.
Best Insoles for Flat Feet
FonsBleaudy Orthotic Insoles with Arch Support
These insoles are highly recommended by podiatrists and made with high-grade materials and premium design. They are used in the treatment of knee pain, shin splints, and Achilles tendonitis.
The fabric used in its manufacture is anti-slip and provides cushioning and support foot alignment. It is also designed to help to prevent sports injuries, relieve pain, ease stress and provide support for fallen arches.
The insoles help to distribute weight evenly and protect the heel from the impact of walking, hiking and running.
The materials used are lightweight and breathable and can be cut down to size. They also absorb sweat and help the feet to stay cool and dry during physical activities.
These ¾ orthotic insoles are designed to provide arch support and comfort for people with plantar fasciitis, flat feet, and heel pain. They help to stabilize the feet and adjust them to proper alignments.
The 35mm high arch support is used to correct fallen arches. The stiff EVA materials used in the production of the insoles help to provide support to the foot and reduce pressure from the heel.
The materials are breathable and do not require any cutting or size adjustment. It can fit into any type of working or casual shoes.
Samurai Insoles Instant Relief Orthotics for Flat Feet
They are designed by a podiatrist and a team of experts to address the root cause of pain and fatigue of flat feet.
They are used to gently correct the effects of fallen arches and provide soft support of the feet. They are built to offer quick relief from heel pain and plantar fasciitis for people who cannot tolerate rigid insoles.
They are slim, lightweight and are available in various shoe sizes. They provide ample support, bounce and cushion to the arch and are suitable for running, jumping, jogging, skiing, cycling and walking.
Footminders Comfort Orthotic Arch Support Insoles for Sports Shoes and Work Boots
This insole has a firm arch support design that helps to reduce foot pain caused by flat feet and plantar fasciitis. It is highly recommended by chiropractors and podiatrists.
It can be used with work boots and all sports shoes. It is also ideal for people that walk or stand for a long time.
They are specially designed to provide cushioning from impacts of walking, running, standing and hiking on the feet. It also helps with the biomechanical re-alignment of the hips, knees, ankles, and feet.
This insole is designed to be used on wide and thick shoes like basketball shoes, work boots, running shoes, and the likes.
It is produced with premium materials that cool down the feet and offer excellent shock absorption. Its arch support design helps to improve foot alignment, ease pain and stress caused by flat feet and other foot disorders and provide comfort.
It has a deep heel cup that protects the heels from impacts from walking and running and can be used every day.
EasyFeet Plantar Fasciitis Arch Support Insoles for Men and Women
These are premium shoe insoles recommended by podiatrists which helps to minimize pain and offer comfort. It is used to relieve pain from flat feet, plantar fasciitis, back pain, knee pain, ankle pain, heel spurs, shin splints, bunions, and metatarsalgia.
They can be used in basketball, casual, sports, hiking, tennis, snowball, golf, ski, work, and orthopedic shoes.
It is designed with the Anti-pronation Biomechanical Reinforcement Technology that offers a great level of arch support, comfort, and stability.
The arch support made with hard thermoplastic polyurethane and a foam base of premium quality. The breathable top material reduces friction and heat and provides comfort. These insoles can be trimmed to fit different sizes.
Physix Gear Sport Full Length Orthotic Inserts with Arch Support
These are designed to balance the foot structure and provide convenient and soothing relief to those with shin splints, flat feet, Achilles tendonitis, and runner’s knee. It helps to relieve heel pain, metatarsal pain, and correct abnormal gait.
The materials used are of high quality, durable and are medical grade. The EVA foam and polyurethane material provide a cushion effect that feels like walking on clouds.
The deep heel cup provides stability while the ultra-thin top fabric pampers the feet during physical activities. They can be used for rock climbing, sports, ball games, camping, running, and d jogging.
They are also perfect for those that stand on their feet for a long time (factory workers and retail employees) and they provide long hours of cushioning and comfort.
The ergonomic non-slip design provides support for correct foot posture and is carefully produced to reduce pain and discomfort. It is also designed with more room at the toe box so that it can fit into any type of shoe.
The non-slip heel stays in place all day and provides exception shock absorption.
The processes involved in the production of orthotics are intricate and detailed. It involves multiple steps and strict adherence to the prescriptions of the podiatrist.
There are three main steps taken in the production of orthotic insoles. These steps are casting, manufacturing and cushioning.
Step I: Casting
In this stage, the legs are thoroughly examined, and measurements are also taken. The foot cast is taken in a neutral position, either lying or sitting down to avoid the wrong impressions due to body weight.
The cast of the feet is taken with the use of a wet plaster wrapped around the foot and allowed to solidify.
The semi-hard hollow mold (positive mold) is filled with another mold (negative mold), allowed to sit for 24 hours and the flexible mold removed. The solid mold which has the same dimensions as the legs of the user is taken to the laboratory.
Step II: Manufacturing
The negative mold is taken to the laboratory and together with the materials, measurements and other accessories to be used in the production of the orthotic.
The cast is pressed on the material to be used to produce the orthotic under very high temperatures.
There are different materials that are used in making orthotics. They are to be comfortable, durable, flexible and strong enough to bear the forces that the bodyweight put on the feet. Some of these materials are plastics (polypropylene) and graphite.
They are materials made up of elements like carbon, hydrogen, nitrogen, oxygen, Sulphur, and chlorine. They have high molecular weight and are called polymers.
The production of plastics is based on the carbon atom and it joins with oxygen, Sulphur, hydrogen or nitrogen to form long chains of a polymer called thermoplastics. 97% of plastics are thermoplastics.
Thermoplastics can melt and they are made up of identical repeated small units called monomers. Some monomers can be short while some are very long. When these monomers are joined in a process called polymerization, they become polymers.
The bonds that join the carbon atoms to other elements in thermoplastics are single bonds. When the bonds that join the carbon atoms and the other elements are double or triple bonds, the end-product is called thermosets.
Thermosets cannot melt and are used in making adhesives, polyester, bathtubs and boat hulls.
Polymerization is of two types:
Addition or Chain-Growth Polymerization
This occurs when monomers form a branch or linear structure to form a polymer without the loss of an atom or molecule. The four types of addition polymerization are free radical polymerization, anionic vinyl polymerization, cationic polymerization, and coordination polymerization.
This type of polymerization is used to produce plastics like polystyrene, polyethylene, and polyvinyl chloride.
Condensation or Step-Growth Polymerization
This is a process by which small molecules react with one another to form larger units and produce a by-product like water, methanol or HCl gas. The by-products are removed before this process can produce the intended products.
Sometimes, these by-products are useful as raw materials for other manufacturing processes and can be reused.
Nylons and polyesters are made through this type of condensation polymerization.
When the monomers involved in the polymerization process are the same, the polymer produced is called a homopolymer. When the monomers are not identical, the end-product is called a copolymer.
This is one of the forms of natural carbon found in igneous and metamorphic rocks. It is very soft, has very low gravity, inert (doesn’t react with other elements), has a very lightweight and heat resistant.
These properties make it a very useful material for the manufacture of many products.
There are two forms of graphite, natural and synthetic graphite.
This is formed when the carbon in the earth crust is subjected to temperatures as high as 750oC and pressures as high as 75000lb/sq. in.
There are three forms of graphite namely flake (formed from regional metamorphism), amorphous (formed from coal stem metamorphism), and lump graphite (formed from hydrothermal metamorphism).
This is produced when a hydrocarbon is converted to coke by heating in the absence of oxygen, then calcinated and heated to about 3000oC.
There are two forms of synthetic graphite: graphite blocks and electrodes. Graphite blocks also known as isotropic graphite are used for energy storage while electrodes are used in furnaces for melting iron.
Step III: Cushioning
Materials that cushion the hard plastics and graphite are used in cushioning the orthotic to provide more comfort.
The materials commonly used to cushion the plastic and graphite core of the orthotic insoles are polychloroprene, ethyl-vinyl acetates, and silicones.
How to Make A Good Choice of An Insole
The type of insole to be used is determined by a lot of factors. Although insoles are produced to provide support and comfort, it is very important to buy the right insoles.
Some of the factors to consider while choosing an insole are arch type, gait, and purpose of purchase.
There are three types of feet arches which are
A normal arch is also known as the neutral or moderate arch. The body weight is distributed evenly by this type of arch and is efficient biomechanically.
Stress and poorly fitted footwear can make this type of foot susceptible to foot disorders like posterior tibial tendon dysfunction, metatarsalgia, and heel pain.
Insoles for this foot type should provide enough cushioning and comfort to prevent foot pain.
High arch also is known assupinated or Cavus foot is very rigid and the force exerted on the foot by body movements is absorbed by the heels and forefoot. This causes pains in the weight-bearing parts especially after physical activity like running.
This type of foot is likely to develop foot disorders like arch strain, foot calluses, plantar fasciitis, metatarsalgia, claw toes, and heel pain.
The orthotic insole for this foot type should have a thick metatarsal cushion and superb arch support to help in shock dispersion.
Flat arch is also known as the flat or overpronated foot which can be flexible or rigid. The force exerted on the foot by the body is directed back to the knee and hips.
This type of foot is likely to develop foot problems like bunions, knee pain, tendonitis, plantar fasciitis and, heel spurs.
The orthotic insole for this foot type should provide arch cushioning and thickness that can help with foot alignment.
This is simply defined as the way a person balances and coordinates the muscles while walking. Gaits can be normal or abnormal. Abnormal gaits can be caused by factors like inner ear dysfunction, stroke, arthritis, nervous system disorder, and tight shoes.
Types of abnormal gait are
Parkinsonian gait also is known as propulsive gait is characterized by a head that is bent forward and a stooped posture.
Spastic gait also is known as ataxic gait is characterized by a dragged foot and stiff muscles. This is normally caused by nerve-damaging diseases like polio.
Hemiplegic gait is characterized by a leg that is more extended than the other. During movements, the affected leg cannot be lifted but swung. It is caused sometimes by stroke
Waddling gait also known as myopathic gait is characterized by bent hips that are shifted to maintain proper balance. Pregnancy and muscular dystrophy can lead to this type of abnormal gait.
Scissors gait also is known as diplegic gait which is characterized by legs that are swung at the waist and knees that are slightly bent. The knees and thighs cross and hit each other during movements like scissors. This is found in people with cerebral palsy.
Steppage gait or neuropathic gait is characterized by a hanging foot and toes that drag while walking.