Attached is a test for a flexible flatfoot.
- Frame 1: At heel contact, the ILA is intact
- Frame 2: At foot flat, ILA collapses to the ground
- Frame 3: Heel raise, the Windlass Mechanism kicks in and the ILA is partially restored
Dear Brian,
That is an interesting question.
In my opinion, I think that a flexible flat foot is not a diagnosis or a symptom of anatomic deformity, because the hold of the plantar arch is a complex mechanism composed of different elements such as bones, ligaments, aponeurosis, and muscles. So, it is possible to see subjects with high flexibility that produces an important fall of the longitudinal medial arch, but that does not necessarily mean the existence of a mechanic or anatomical problem. For example, Eliud Kipchoge the marathon record man develops hyperpronation in each footstrike (https://youtu.be/8VXLiCzFyvg).
I think that the movement pattern is produced by a conjunction of the anatomical structures, external loads, and neural control.
I will pay attention to this discussion.
Greetings!
Dear Celso,
IMO, the term flexible flatfoot is a symptom, not a diagnosis. It is a symptom because it describes a foot where the ILA collapses during gait. What causes that foot to have a flexible flatfoot? That determination would be the diagnosis.
In 2002 I published a paper that presented 2 previously unrecognized inherited foot structures - the PreClinical Clubfoot Deformity and the Primus Metatarsus Supinatus foot deformity - both deformities result in flexible flatfoot.
Comments?
In My opnion flexible flat foot is symptom occurring in specific foot deformities.
I agree. IMO, flexible flat foot (Progressive Foot Collapse Disorder) is a symptom, not a primary diagnosis. There are several inherited foot abnormalities that force the foot to collapse during closed kinetic state (standing/walking). Specifically the PreClinical Clubfoot Deformity and the Primus Metatarsus Supinatus foot deformity
Thank you for this information..
Respected sir, please share recent evidence for treatment of functional flat feet.
Regarding Progressive Foot Collapse Disorder (functional/flexible flat feet), I have no double blinded, statistical papers to offer. However, I do have nearly 50 years of clinical experience to share.
In my experience, if the practitioner first determines the cause of the foot collapse, the intervention becomes more easily determined.
For example, if the flexible flatfoot symptom is the result of the PreClinical Clubfoot Deformity, I use proprioceptive insoles. These insoles have proven to be very effective in reversing the chronic musculoskeletal symptoms associated with this deformity.
However, if one uses arch supports indiscriminately to treat a flatfoot, the patients subjective symptoms can increase.
Thus the maxim, treat the cause, not the symptoms.
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