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What is Flat Insoles and How is it Treated?

What You Need to Know About Flat Insoles

Flat footbed, also known as low foot, may be congenital or may occur in adults. In short, one can subsequently acquire a flat base. Flat footbed, which is one of the most common orthopedic disorders in the society, is a problem that affects the quality of life negatively. Lack of internal curvature or insufficiency of the sole of the foot is defined as flat insoles. As you can see in the picture below, the base of the foot in the number 1 is completely flat. This means flat insoles. In figure 2, the foot has an ideal inner curve.

straight-footbed-002.jpg

Flatness, which is a problem that negatively affects a person's quality of life, causes various health problems such as early fatigue, foot pain, stepping in, knees hitting each other and low back pain. Therefore, one's daily life is negatively affected. As the age of people with flat soles progresses, deformities of the feet and calcification of the waist are seen. The feet are loaded with almost the full weight of the body. The feet allow the foot to flex from the heel during walking, thus assisting the body's spring mechanism. It is completed smoothly thanks to the spring movement and the curvature of the soles. However, in the absence or lack of internal curvature, flat base is mentioned. The quality of life decreases as a result of situations caused by flat-bottomedness.

straight-footbed-dereceleri.jpg

What are Flat Insoles?
Flexible Flat Insoles
It usually improves spontaneously after 8-10 years of age. In the case of flexible flat insoles, the curvature is visible when the foot is idle, but when the floor is pressed it is flattened.

Rigit Flat Insoles
Unlike the flexible flat sole, the foot does not have any curvature, either at idle or on the ground. Rigid flat insoles usually arise as a result of disordered bones in the foot. Rigid flat insoles that do not improve spontaneously can cause permanent problems if left untreated.

What Causes Flat Insoles?
First of all, we should state that every human being is born flat. After 5 years of age, the tissues forming the foot arch become more pronounced and strengthened. So each individual is a flat base until the age of 5. Completion and strengthening of the tissues forming the foot arch continues until the age of 9-10. Until the age of 5, the soles of the feet have not yet developed and are covered with a thick fatty tissue. Many experts recommend that children walk barefoot until they are 5 years old. Toddlers are recommended to wear mes-style soft leather shoes. On the contrary, the development of foot muscles and ligaments is adversely affected if hard shoes are worn. It is also recommended that children wear shoes called anatomical or physiological, not orthopedic shoes.

When it comes to flat insoles, it comes to mind that it is usually a congenital disease. However, flat base may be congenital or may occur later. We can say that people with normal and healthy foot structure may develop flat insoles after 30-40 years of age. The flat base, which can be obtained in later years, may also develop due to rheumatologic diseases or overweight. The tendon called “tibialis posterior asında is located at the very apex of the foot arch. The degeneration of this tendon adhered to the bone as a result of factors such as age, weight, overuse and rheumatologic diseases and its inability to function are the main causes of flatness seen in adults. If this tendon supporting the foot arch degenerates and does not work well, the cavern will slowly collapse.

What are the Symptoms of Flat Insoles?
The flat footing seen in adults progresses insidiously and causes the foot arch to collapse slowly. At the same time, the patient feels a pain in the inside of his foot. As with any disease, early diagnosis is of great importance in the flatfoot problem. Advancement of the disease can be halted by measures taken in early diagnosed flat floor cases. However, in the early stages, however, the disease cannot be diagnosed immediately and is confused with other diseases. The main symptoms of flat insoles seen in both children and adults are; The internal curvature of the foot slowly collapses, early fatigue, shortening of walking distance, pain during walking, leg and knee fatigue. As a result of the collapse of the inner curvature of the foot, the heel makes outward reclining motion. This results in knee and low back pain. Subsequently, deformities of the fingers occur in the anterior part of the foot.

Feet in
Quick fatigue
Pain in the tibia at the end of the day
Reduction in sports ability
Increased low back pain
Pain with walking

What is Flat Insole Treatment?
Untreated flat insoles may result in disability. Therefore, the problem of flat insoles seen in both adults and children should be treated. In untreated flat sole cases, the disease progresses and the person is unable to walk, deformation in the joints, heel-shaped disorder, low back pain, knee pain and toe deformities are observed.


In the treatment of flat insoles, first of all, shoe change is made. In the course of treatment, preferred shoes should support the foot and include soles that take the shape of the foot. In this process, it is recommended that the patient lose weight and not overuse his feet. If there is no positive result from shoe and insoles treatment and the disease has reached advanced stage, surgical intervention is applied.

WARNING!

Written and visual contents in our content are compiled from different sources, suggestion and information letter. There is no definitive diagnosis and treatment. In case of any health problems, consult your doctor. Remember that the treatment methods used in health problems may vary according to the individual's biology, hereditary characteristics, age, height, weight differences, allergic aspects, and dozens of different conditions. Your doctor can help you in the treatment of your health problems.


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WHY SHOULD WALK ANALYSIS BE DONE?

Analysis with our pressure (pedobarography) devices gives us the mean and maximum pressure values in Newton kilos pascal during swing stance.

In the light of these data, we can observe how much the person presses in, how much outward pressure, how much pressure is formed in the heel, how big the callus occurs in which part of the foot or may occur, the sensitivity points between diabetic foot or the pressure differences between the right foot and the left foot. All evaluations shed light on the design of our personal base. It helps us to determine the shore of the insoles raw material.

Gait analysis; In the production of personalized insoles, it gives us information about which material should be the sole.


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Orthopedic boots and insoles are unnecessary for children

Many of the children toddler parents start looking for orthopedic shoes, boots in the store. Parents often become easy customers of sellers who say ‘our shoes are orthopedic, and insist on the protrusion placed in the middle of the shoes.
They lose millions of pounds for the health of children with the most sensitive points in a pen. However, if children do not have serious health problems, there is no medical necessity such as orthopedic shoes, ankle boots, and insoles.

Is it normal for toddlers not to step straight?

It is mostly not a sign of illness, as they are a little trapezoid, and children between the ages of 2-6 are slightly flat. Scientific studies show that most of the 2-year-old children's base is on the ground, which means that there is a slight flatfoot. However, by the age of 5, the foot structure spontaneously improves. As it grows, the shape of the surface of the foot changes. Normal base view occurs.

l Isn't orthopedic shoes essential?

No child should wear special shoes except for very rare bone diseases. Orthopedic boots, various insoles, plastic molds made from the mold of the foot used to prevent trapezoidal or flat soles in children are often unnecessary, disturbing and expensive.

Are there any scientific data required to use them?

No. This practice has no scientific basis and does not prevent flatfoot. It does not contribute to proper printing. The bones and ligaments of the growing child develop naturally. 5- By the age of 6, the child starts to walk like an adult. Early diagnosis of all health problems facilitates treatment. However, orthopedic boots or insoles are of little use to children from trapezoidal footsteps.

When did the Western countries leave?

It was completely abandoned in the 1960s. In our case, orthopedic boots are still used, which make it difficult for children to walk, disturb their feet and burden the family budget. There are even doctors who require the child to travel in these heavy and bulky boots from morning to night.

What should be considered when choosing shoes for children?

- Made of comfortable, lightweight, flexible material,

- Easy to wear and remove,

- Choose cheap shoes.

- Comfortable shoes prevent irritation of the child's gentle skin.

- In light and flexible shoes, the foot moves more comfortably. Makes it easy to run and play. Easy to wear and remove shoes are good for mother and child.

Do I need to wear shoes at home?

The child should walk around the house as barefoot as possible without shoes.


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Duz Flat insoles up to the age of 5 and normal pressing basma

Orthopedics and Traumatology Specialist stated that flat footing should be evaluated as a result of normal development process in children until the age of 5 years. Dr. Mithat Oner said that there is no need to use a special insoles or shoes before this age.

Orthopedics and Traumatology Specialist Dr. Mithat Oner, until the age of 5 scientifically "flat insoles" can not be diagnosed, continuing after this age of flat insoles should be treated, he added. Stating that families' intense concerns about the flat insoles of their children at this age, it leads to abuse such as the sale of special insoles and special shoes. Dr. Öner continued his words as follows:

No need for special insoles and shoes
Kadar It should be known that almost all children up to the age of five have a flat base. This is a scientific fact. The sole of the foot anatomically completes itself at the end of the 4th year. So there is no need to worry early. This issue is very vulnerable to abuse. Recently, sales of special insoles or special shoes are made under foot scans, which go down to kindergartens. Children are examined and situations that cause families to be worried are revealed. Care must be taken against this. Because it is not possible for children to be diagnosed with a flat base before the age of five. 5

Professor Öner advised children before the age of 5 to walk barefoot at home and to wear only soft shoes outside without the need for extra features.

Children after the age of 8, two feet stuck together each other, pain and prevent the sport should be started in situations that prevent treatment. Dr. Öner, ’85 percent of flat insoles are flat insoles that do not require treatment and do not cause problems in the daily life of the child. The remaining 15 percent are conditions that are an underlying disease, such as congenital bone deficiency or excess, which the orthopedic surgeon should intervene. They will be best treated by orthopedic surgeons. The 8-12 age range is the age range that responds best to the treatment. I


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Flat insoles are not fate!

Foot and Ankle Surgery Specialist Dr. Tahir Öğüt stated that flatfoots with pain and past stage should be corrected by surgery, and if the operation is performed on time, it is possible to correct the flatfoot without fixing the joints.

Nobody wants to be called a flatfoot. If you're flatfooted, you're either black-lucked or blind-lucky. Neither your business goes random, nor does it laugh at you. Although rumors continue like this, flatfoot is not fate. Liv HOSPITAL Foot and Ankle Surgery Specialist from Orthopedics and Traumatology Department. Dr. Tahir Öğüt gives information about the flatfoot.
What kind of complaints does flat footbed cause?

We can roughly evaluate flatness in two separate groups. One is flatfoot, which is present since childhood, and the other is the development of flatfoot in a person called '' adult type '' whose feet are normal as a child.

· The foot gradually deforms over time. This is a progressive condition and the rate of progression varies from person to person, depending on usage and genetic structure.

· The pit on the inside of the foot starts to collapse, the toenail of the toe is looking at the ceiling before it is looking at the other foot, the heel starts to slide out slowly. As the deformity increases, a protrusion begins to form on the mid-inner side of the foot.

· A person cannot stand up or have difficulty getting up on one foot.

· Pain in the middle-inner side of the foot at first, but later in the foot pain in the outside. In short, pain and deformity are the main symptoms of flatfoot.

· Deformation occurs in shoes.

Mistakes

Unfortunately, when such a patient is admitted to a doctor, MRI is often required for examination. The patient wanders around the doctor with MRI scans under the chair and is told that he should usually use only a pair of insoles. Even if the patient is a child, special shoes are recommended and families are satisfied. However, normal foot X-rays taken while standing are sufficient to diagnose and determine the degree of flatfoot. MRI is extremely unnecessary. Special shoes have no place in the treatment of flatfoot.

How should it be treated?

First of all, an orthopedist experienced in foot care should be consulted. Treatment is based on the degree of flatfoot. In the first stage, insoles may be used. Insoles do not relieve flatness but can relieve pain and reduce progression. The insoles used must be personal. Unfortunately, it is very rare for patients to see a doctor at the initial stage and to make a correct diagnosis even if they do. Once this stage has passed and foot deformity begins to occur, the soles do not help much. Flatfoot with pain and past stage should be corrected by surgery. If the operation is performed in a timely manner, it is possible to correct the flatness without fixing the joints, but in delayed cases, the only remedy is to fix (freeze) the joints. Flatfoot surgery gives patients a better quality of life.

When does the patient return to normal life after surgery?

This depends on the age, stage and technique of surgery. While the patient can step in one to two weeks in the screwing technique used in special cases in children, the foot is usually held in half plaster, which we call splint, for 6 weeks after other methods we use more. You can walk with the aid of a walker or crutch by pressing the intact side within 6 weeks, but the surgical foot is not pressed for 6 weeks. The transition to normal shoes is between 6 and 10 weeks, depending on the technique used.

What are the complications of surgery?

The most unpleasant part of these surgeries is to be able to stand up immediately after the operation, which is normal. Because people walk on their feet, and if a foot is not fully healed, complications can occur. Apart from that, the risk of complications is negligible when performed by an experienced foot surgeon. If we do not take care of our feet, our quality of life will deteriorate and our life will be affected by our feet.

Causes of flatfoot in adults

Excess weight

Old and untreated old foot and heel fractures

Abuse: Unsuitable footwear, excessive strain, trauma

Rheumatologic diseases

Diabetes


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Shoe insoles must be the same as foot size

Professor Dr. Mehmet Halıcı said that the external insoles used for the comfort of the shoes should be the same as the foot number in order to be functional.
According to the daily activities of those who have to wear shoes that are not very suitable for foot orthopedics such as sneakers or boots, they can make their shoes comfortable with external insoles. Dr. Carpet, gave information about the issues to be considered when buying insoles. First of all, Prof. insists that the insoles should be the same as the foot number. Dr. Halıcı said, büyük One of the biggest mistakes when purchasing these insoles is; removing insoles that do not correspond to the foot number. If the insoles are shifted inside the shoe, it can become a grind rather than a solution to the patient's problems. Therefore, the insoles must be large enough to grasp the shoes. In addition, the use of insoles, normal shoe size half or a number of large shoes to buy another important issue, ”he said.

Selection of insoles should be made according to the purpose
There are two types of external insoles, including half and full. Dr. Halıcı, pointed out that the purpose of using both soles are different from each other. He pointed out that half-soles were used for heel elevation or to relieve the feet of patients with heel spurs. Dr. Halıcı said, “We also use full soles to support the foot arch or arch and increase foot comfort, especially for people with flat soles or people with daily activity with traditional shoes. Therefore, a wide variety of insoles are sold in the market. However, when purchasing them, attention should be paid to the purpose of being used as well as being of good quality ”.


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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.


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