Foley Physical Medicine
Oh, My Tired and Aching Feet
Does having flat feet make you more tired? Do flat-footed people have a greater degree of fatigue at the end of a day than people with normal feet? If you ask a flat-footed person these questions, you'd hear a resounding, "Yes! How did you know?"
Having flat feet, or what is more accurately described as 'over-pronated feet', causes a person to use more energy in walking. Over-pronation is a more accurate term because even those with arches that appear high can have the same clinical picture as those with overt flat feet.
During gait the foot goes through several subtle movement changes. Pronation is one of these movements. Pronation occurs when your lower leg rotates inwards from the knee down. In this position, your foot is wider and longer. The pronated foot is flexible and it happens just after your heel strikes the ground. Pronating at this time makes your foot flexible thereby allowing it to adapt to the ground you've just stepped on.
The term 'over-pronation' means that the foot is in a flexible position all the time and this isn't good. There are times in the cycle of walking and running that the foot must be rigid to form a firm lever for the leg muscles to pull against. Rigidity in the foot should occur as the foot is propelled forward towards the next step. The motion that makes the foot rigid is the opposite of pronation called supination.
If the foot is pronated or flexible at the point of propulsion instead of rigid or supinated, much of the explosive muscle power required from the legs is lost to the loose joints of the foot. So people with flat or over-pronated feet have to use a lot more energy than those with normal feet to walk or run. This extra energy really adds up during the course of a day and the overall net result is fatigue and tired and aching feet.
For many years, health practitioners have reasoned that this should be the case with people with flat feet who complained of fatigue or aching legs and feet. Now thanks to a recent study, the common theory seems to be proven.
This theory was proven by a research project reported in the Journal of the American Podiatric Medical Association (2000;90:30-34). Two groups of women were used in the study. One group was made up of 20 women who had normal feet while the other group of 20 had over-pronated feet confirmed by weight-bearing analysis and x-ray studies. The study consisted of both groups walking on a treadmill at 3 different speeds and inclines. Multiple measurements were taken during this period of exercise: ECG, blood pressure, pulse rate and oxygen consumption; both before, during and after the exercise.
Then the flat-footed women were given custom-made arch supports to wear for 2 weeks prior to a second study. After the 2-week period the treadmill exercise was repeated with both groups, and the overall results were compared.
In both tests, the control group of normal feet showed no difference in any of the measurements while the flat-footed group had significant differences in both their walking and post-exercise measurements. With the arch supports, the study group had lower heart rates, lower blood pressure, they used less oxygen and the math showed that they used less energy to do the same amount of exercise. Interestingly, the differences were more noticeable at higher speeds and greater inclines. In other words, those with flat feet could expect to be more tired if they did more work.
So the only difference in the 2 study periods was the use of custom-made arch supports in the flat-footed group of women. Custom-made arch supports are more commonly known as orthotics. People with flat or over-pronated feet should take notice here: orthotics really do help. Like eyeglasses, orthotics can be expensive when custom-made, but if they're well fitted and in a proper set of footwear, they're worth every penny.
Interested in having your gait analyzed for dysfunction? Call Foley Physical Medicine to schedule an appointment to find out how we can help you with your pain and fatigue.