Flat Insoles
When our feet are evaluated in terms of movement of our body, they are located in important anatomical structures such as our knees and hip joints. It is imperative that we have healthy feet so that we can walk upright with a load on both feet.
One of the most important tasks of the foot is to help the body's load-bearing ability and to perform the walking task. The feet make a stretching movement from the heel to the front of the foot during the step-by-step movement. In this way, they help the body's spring mechanism and allow us to carry our load and walk. The most important area that provides this spring movement in the legs, which allows us to walk and survive painless and long term, is the inner curve (arc) located on the inner side of both legs and which prevents the collapse of the foot when it hits the ground. This inner curve consists of bones supporting the inner surface of the foot, as well as ligaments and muscles that hold these bones together. Like the meniscus on the knee, this inner curve flexes during load to help distribute the weight evenly and evenly to the ground.
What is flat footed?
The absence of this inner curvature, which is one of the most basic structures for walking, is mentioned as flat insoles. In these people, when the feet step on the ground, the inner arch of the foot collapses, unable to bear the weight of the body and causes the foot to become flat. For this reason, this is called flat insoles. Since the load to be transferred from the heel to the front cannot be transferred properly, a balanced load distribution cannot occur at the soles of the feet and in patients, especially after long-term walking, heavy load carrying, long-term standing and sporting activities, various pain, burning, stinging, drowsiness, painful burning, and stinging accompanied by drowsiness.
The most common finding that accompanies flatfoot is stepping in while walking. The deterioration of the load carrying capacity of the foot causes the load to be loaded on the inside of the foot structure and thus the problem of stepping in the foot occurs. This base collapse will not cause any symptoms and discomfort in some cases or diseases, or in some cases it may create some specific complaints and signs. Among these complaints, standing and pain are the most common complaints. Standing pain is usually reflected in the knee, hip and waist. Stiffness may occur in the calf muscles. There may be limitations in ankle joint movements. Calluses on the soles of the feet may occur due to these restrictions due to the regression of the Achilles tendon adhering to the heel. The heel bone can lie outward and cause early wear on the inside of the shoe claw and on the heel. In addition to all these findings, other findings include increased pain with gait, shin bone pain in the evening, especially at night, triggering of lumbar problems that present previously and occasionally cause pain, early fatigue and decreased sporting activity performance. In summary:
• If your feet get fatigued quickly and you have pain in your leg that is increasingly spreading through prolonged standing,
• Pain develops around the heel, and stiffness and contraction occurs in the calf muscles,
• If the pain in your feet starts to hinder your sporting activities,
• If the inner claws of the shoes wear out prematurely and you have weakness in your feet, it will be useful to consult your physician for evaluation of flat soles.
Are there any types of flat soles, if any?
While describing the flatfoot problem, it is essential to evaluate in two different groups, although there are basically many different subtypes.
• The first type, and much more common flat footbed, is the type we call flexible flat footbed. Flexible flat insoles, which are usually diagnosed in childhood, have only loosening and excessive flexibility in the ligaments and muscles without any bone problems. In this table, when the patient's foot does not touch the ground, a curvature is present in the inner region of the foot, but this curve disappears by stepping on the ground and the feet collapse inward. The most important factor in the diagnosis of soft flat soles is to see if the inner arch of the foot is formed when the patient rises at the fingertips. This is an indication for soft flat insoles if a curvature is formed on the inside of the foot when it is raised at the toes.
• The second type of flat foot is a more rigid flat foot which is more rare and usually requires further examination and treatment. In this type, the foot of the patient stands firmly and flatly both during the stepping down and when not touching the ground. When the foot is on the ground, the ankle and heel are bent outwards and the foot is bent inwards, as the foot has no inner curvature. In these patients, as opposed to the flexible flat soles, the shape of the foot does not change and an inner curve does not occur when the finger tip is raised. This type of flat insoles, which is one of the heavy forms of flatfoot, can occur for many different reasons such as congenital or developmental and requires detailed examination by a specialist physician.
Although there are many different shapes and types and acquired type flat insoles after traumas or accompanying sugar or rheumatic diseases, flat insoles described above are most commonly seen. Considering the flatbed as a double-ended fan, this range includes a flexible flatbed, the lightest form at one end, and a hard flatbed, the heaviest form at the other. When you consult your physician, you can find answers to the questions about whether there is any flat insoles, if there is any flat foot, anteroposterior and lateral radiographs to be taken after the physical examination. Advanced imaging modalities such as tomography or magnetic resonance imaging are rarely needed for the diagnosis of flat footing, and an outpatient diagnosis can be made on the same day.
What are the treatment options for flat insoles?
There is no need for treatment if the person with a flat sole does not have any pain, or if there is no fatigue or difficulty in standing, which affects his or her social life, and especially if the flat sole is a flexible flat sole. In other words, the main consideration in treatment planning is the complaints in the patient. In general, these patients complain that their feet step inward while walking with aesthetic concerns. It is sufficient to inform these patients with the necessary recommendations and to warn them about the course of flat footing. There is no need for any physical therapy or special insoles.
In patients who have pain during walking or who start to have pain with long-term social activity and get tired quickly, treatment is required regardless of the type of flatfoot. These patients have a wide range of options ranging from simple life change recommendations to surgical treatment options. Apart from the surgical treatment option, the following should be done:
• Shoe changing (shoe modification), wide selection of soft soles,
• Use of silicone or custom made insoles or orthotics supporting the inner arch of the foot,
• Use of drugs that relieve pain and prevent tissue reaction due to flat soles,
• Steroids and analgesic needle treatments to the ligament of the stretched inner arch due to flat soles to reduce pain,
• Resting and applying cold compress (ice) treatment,
• There are physical therapy options (exercises supporting the inner arch of the foot).
Surgical treatment may be necessary, especially in patients with a stiff flat base that do not respond to the non-surgical treatment options outlined above. Surgical methods used; The aim is to relieve the pain and to re-establish the bone alignment to bring the inner arch of the foot into a load-bearing shape. Physicians interested in foot flat soles and surgery are orthopedic specialists. You should discuss with your orthopedic doctor to decide which surgery should be performed and to discuss with you the possible risks before and after surgery and how to undergo a post-operative rehabilitation process.
35AXX
Happystep Orthotic Memory Foam Insoles Shoe Inserts (Size L: US Men 8-12 or Women 9-14)
