# Flat feet



## Bulldozer (Nov 24, 2006)

I used to have good arches, but over time they have pretty much totally collapsed.

I dont know if its heavy squatting and deadlifting thats done it, or increase in bodyweight. Maybe a mixture of both.

Anybody else have this problem?

Are there any potential probs that may occur due to flat feet ? IIRC i read somewhere once they can lead to knee problems.. Not sure if there is any truth behind that...?


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## Bulldozer (Nov 24, 2006)

All you mofo's got perfect arches then


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## MasterBlaster (Dec 6, 2008)

Bulldozer said:


> I used to have good arches, but over time they have pretty much totally collapsed.
> 
> I dont know if its heavy squatting and deadlifting thats done it, or increase in bodyweight. Maybe a mixture of both.
> 
> ...


Here is a cut and paste for you:

*Cause*

*
*

*
*There are several causes of adult onset flat foot but the commonest is Tibialis Posterior Tendon Dysfunction.

Tibialis Posterior is a large muscle that runs from the calf into the foot behind the inner aspect of the ankle(medial malleolus). Its function is to turn the foot inwards, support the arch and help to initiate tip-toe standing. (Another cause is arthritis which can cause the joints in the middle of the foot to become deformed and so the arch flattened).

The tendon itself may become inflamed initially and so may not function properly. As the inflammation continues it causes the tendon to degenerate and stretch and it will eventually rupture. Therefore the ability of the tendon to maintain the arch is lost and the arch will collapse. Associated with this flattening of the arch will be an outward movement of the heel on standing.

It may be difficult to be certain which came first, the inflammation so causing degeneration or degeneration causing an inflammation. It is certainly commoner in people with diabetes, high blood pressure and who are over-weight. It is also commoner in women aged 40-50years.

the link:http://www.sportsmedsw.com/pages/ten_lig_adult_flat.html

I hope this helps bud


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## Bulldozer (Nov 24, 2006)

Cheers dude


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## anabolic ant (Jun 5, 2008)

i have noticed a lot of the long term bodybuilders,ifbb pro's have quite flat feet...i have fairly flat peds...but never had a problem with it...i did have some knee pain,and when i went to the docs,they said it was all down to my feet etc,sent me to orthotics for insoles and this n that...reckon if i didnt sort this out it'd get worse,but i never had a problem really...and i dont even think my knee pain was related to my feet...i was squatting perfectly with my good ol flats...now with pushed/forced up arches,i dont seem to squat as well...my knees seem to hurt more...i think i was built this way...and if it aint broke,no need for fixing!!!!

i go to the gym without any insoles now,squatting is better without them...i only wear them cos they keep my feet snug in my trainers!!!


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## Tommy10 (Feb 17, 2009)

my left is flatter than my right, bought some inserts from boots, really good...20 quid.


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## Goff (Jan 19, 2009)

I have flat feet, but mine are naturally occuring.

Im also in my 3rd year of a 4 year degree in Prosthetics and Orthotics so i know a bit about feet!

Tibialis Posterior Tendon Dysfunction is usually diagnosed in 4 stages

Stage I is usually a mild swelling and a little bit of ankle pain on the medial (inside) but your foot doesnt show any signs of deformities

Stage 2 is a progressive flattening of the arch,and your midfoot would be abducted (turned away from your body)

Stage 2a the tendon isnt working as it should but your foot would still be flexible

Stage 2b - the tendon does not work properly or is ruptured

Stage 3 - includes everythign in stage 2 and your hindfoot (heel) is fixed so you cant move it.

Stage 4 - you need surgery!

Do you have any pain at all?

Usually if you have pain in your knees it CAN be related to your feet or even your hip as you tend to compensate for problems in these areas thus transferring it to another area such as the knee, so youshould ge it looked at.

I no longer use the hack squat because it plays havoc with the knees and can cause no end of problems purely because of the misalignment of your body when you use it.

Hope this helps!


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## heavyweight (Jan 26, 2009)

Goff said:


> I have flat feet, but mine are naturally occuring.
> 
> Im also in my 3rd year of a 4 year degree in Prosthetics and Orthotics so i know a bit about feet!
> 
> ...


my nan corrected her naturally flat feet from doing exercises.


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## pod13 (Aug 26, 2008)

anabolic ant said:


> i have noticed a lot of the long term bodybuilders,ifbb pro's have quite flat feet...i have fairly flat peds...but never had a problem with it...i did have some knee pain,and when i went to the docs,they said it was all down to my feet etc,sent me to orthotics for insoles and this n that...reckon if i didnt sort this out it'd get worse,but i never had a problem really...and i dont even think my knee pain was related to my feet...i was squatting perfectly with my good ol flats...now with pushed/forced up arches,i dont seem to squat as well...my knees seem to hurt more...i think i was built this way...and if it aint broke,no need for fixing!!!!
> 
> i go to the gym without any insoles now,squatting is better without them...i only wear them cos they keep my feet snug in my trainers!!!


Some good posts on here guys. As MaxMuscle has already said, tibialis posterior tendon dysfunction is a pretty common cause of adult acquired flatfoot. There's also a number of other reasons. I presume you're fit and healthy no diabetes, rheumatoid arthritis, neuromuscular disorders, etc...

Many people have flat feet and have no symptoms. In this case I'm 100% with anabolic ant - if it ain't broke don't fix it. I have flat feet and get pain in a couple of ligaments around my ankle joint if I don't wear my custom foot orthoses and do sport that has lots of running about and changes in direction (eg. squash, rackets, etc...) but I don't get pain from squatting, calf raises or deadlifts.

Shop bought insoles might be worth a go initially, but they can set off a bit of leg pain sometimes, so don't persevere if you start getting pain when you don't have too much in the first place. One exercise I get patients to do with tibialis posterior tendon dysfunction is like a seated calf raise. You sit on a chair with your knee flexed at 90 degrees and barefoot. Make sure you keep your knee above your foot and don't let it move away from the midline of your body (laterally). Do a seated calf raise move (tiptoe while sat down). You notice an arch is established when you're at the top of the move. Now, after this, you've got to bring your heel back down to the ground slowly (approx 10 seconds) whilst maintaining the arch. To do this you need to use your deep muscles in the back of your leg (tibialis posterior, flexor digitorum longus and flexor hallucis longus) but you'll also use some of the small muscles in your arch. It's difficult to explain on here and generally better to see people and show them how to do it. Maybe getting to see a podiatrist could be worthwhile, although, if you're not in pain you could save yourself a bit of money by carrying on as you are.

In theory, flat feet should cause all sorts of problems in your foot and lower limb (some people also believe that you can get back pain related to flat feet) but there's no conclusive proof that they do.

It's up to you really, if you're worried about it, get it checked out - especially if you're in any pain. If you catch tibialis posterior tendon dysfunction at its early stages, you can get away with exercises, orthoses and the right footwear. If it's left alone, you'll be in for surgery that'll put you out of squatting for quite some time.


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## Tommy10 (Feb 17, 2009)

Goff said:


> I have flat feet, but mine are naturally occuring.
> 
> Im also in my 3rd year of a 4 year degree in Prosthetics and Orthotics so i know a bit about feet!
> 
> ...


it does....think I'm a 2a....left foots never been the same since my 3 back surgeries to correct slipped discs...it turns out slightly to the left...have to conciously turn it in when working out.....think it started because i relied on my right leg for almost 4 years...its fine though, no pain


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## Goff (Jan 19, 2009)

Pelayo said:


> it does....think I'm a 2a....left foots never been the same since my 3 back surgeries to correct slipped discs...it turns out slightly to the left...have to conciously turn it in when working out.....think it started because i relied on my right leg for almost 4 years...its fine though, no pain


As pod13 says if you get any pain or are worried about it at all go speak to your GP and see if they will refer you to an orthotist who can take a loot at your foot and see what, if anything, needs to be done :thumb:


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## pod13 (Aug 26, 2008)

Goff said:


> As pod13 says if you get any pain or are worried about it at all go speak to your GP and see if they will refer you to an orthotist who can take a loot at your foot and see what, if anything, needs to be done :thumb:


Ha haa! Nice one, but what I actually said was go see a podiatrist (ideally specialising in biomechanics and/or podiatric surgery). Good to see your tutors are pushing their professional boundaries issues onto their students  Aside from the Johnson & Strom classification you've been taught (modified by Myerson) - have a look at the Conti classification for tibialis posterior tendon dysfunction (that incorporates imaging of the tendon) and the Truro classification system (both available via pubmed). All these classification systems are very American - classifications are published for everything over there. The weird thing about them is that (depending what you read) someone who presents with a stage 2b (Myerson/Johnson & Strom) will go straight for a surgical flatfoot correction, whereas you or I might at least try conservative care first (some even suggest tendon debridement as an option for stage 1 or 2a - bit worrying for Pelayo). A lot of research is quite prescriptive about this sort of thing, so it's worth having a read around.

There's always a nicer option in my opinion, whether you see an orthotist, a podiatrist or a physio, I'd at least try orthoses, footwear and splints prior to considering surgery. At least you can take these out of your shoes if they don't work - it's a bit more difficult to do this with surgery!

Goff - are you doing your degree at Salford? If you're a 3rd year, you might be on your placement so I presume you're not missing the Brian Blatchford building too much?


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## pod13 (Aug 26, 2008)

Pelayo said:


> it does....think I'm a 2a....left foots never been the same since my 3 back surgeries to correct slipped discs...it turns out slightly to the left...have to conciously turn it in when working out.....think it started because i relied on my right leg for almost 4 years...its fine though, no pain


It could be that it is a style of walking that you've learned, or it could be a neuromuscular issue with your history of surgery on your back. My advice would be to get to a physio for an assessment and some gait re-training (might be worth pm'ing phys sam on these boards for further advice on this). If this isn't enough and you start to get pain, a pair of orthoses might help as well. Good luck.


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## Goff (Jan 19, 2009)

pod13 said:


> Ha haa! Nice one, but what I actually said was go see a podiatrist (ideally specialising in biomechanics and/or podiatric surgery). Good to see your tutors are pushing their professional boundaries issues onto their students  Aside from the Johnson & Strom classification you've been taught (modified by Myerson) - have a look at the Conti classification for tibialis posterior tendon dysfunction (that incorporates imaging of the tendon) and the Truro classification system (both available via pubmed). All these classification systems are very American - classifications are published for everything over there. The weird thing about them is that (depending what you read) someone who presents with a stage 2b (Myerson/Johnson & Strom) will go straight for a surgical flatfoot correction, whereas you or I might at least try conservative care first (some even suggest tendon debridement as an option for stage 1 or 2a - bit worrying for Pelayo). A lot of research is quite prescriptive about this sort of thing, so it's worth having a read around.
> 
> There's always a nicer option in my opinion, whether you see an orthotist, a podiatrist or a physio, I'd at least try orthoses, footwear and splints prior to considering surgery. At least you can take these out of your shoes if they don't work - it's a bit more difficult to do this with surgery!
> 
> Goff - are you doing your degree at Salford? If you're a 3rd year, you might be on your placement so I presume you're not missing the Brian Blatchford building too much?


:laugh: yes, you are quite correct - the tutors do push our professional boundaries - although we do have great working relationships with the physios and pods at the mo - could change when we qualify though! :laugh:

A lot of our course is biomechanics, and we have several exams in it as we need to know this for both prosthetics and orthotics. And yes, i too (in my stoodent wisdom lol) would also try to exhaust every avenue before considering surgery. As for the other classifications - i have heard of Conti, but i shall take a look at the others - thankyou.

Yes i am at Salford Uni but I am not on placement yet - thats in September - funnily enough i went to the limb centre at Preston yesterday to take a look around as i will be doing 6 motnhs prosthetics and 6 months orthotics there - looks like a really nice centre!

This course is mainly classroom based which is a bit pants cos you cant learn that much stuck in a lecture theatre, and we only ever have one placement for one day in the first year and thats it until we reach the 4th year! We have clinics year round at the uni, but thats about it - a lot of it is "self-directed study" which can be a pain in the ass when you got 3 kids!


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## pod13 (Aug 26, 2008)

Goff said:


> :laugh: yes, you are quite correct - the tutors do push our professional boundaries - although we do have great working relationships with the physios and pods at the mo - could change when we qualify though! :laugh:
> 
> A lot of our course is biomechanics, and we have several exams in it as we need to know this for both prosthetics and orthotics. And yes, i too (in my stoodent wisdom lol) would also try to exhaust every avenue before considering surgery. As for the other classifications - i have heard of Conti, but i shall take a look at the others - thankyou.
> 
> ...


Preston's a decent night out too, which is always good.

Self directed study - tell me about it (I'm doing a PhD at Salford and use the gaitlab in your building), it's a method of lecturers fobbing off teaching time and the uni saving money in teaching/classroom time that puts all the work onto the student. To an extent, I think this is good as it helps you to be a self-sufficient learner (as degree students should be), but with more 'vocational' qualifications like P&O, physio, podiatry, etc... I think more hands on practical stuff works better. Having said that, a lot of the biomechanics I was taught was crap, so I spent a lot of time re-learning it and looking at other theories of functional anatomy and methods of assessment (kinematic analysis, etc...).

Best of luck with your future career and who knows - you might be sorting out some of my surgical patients out at some point?

Not wanting to hijack this thread or anything, I should post something relevant for the OP - there's no absolute proof that flat feet are a bad thing, but if they hurt, get them checked out.


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