Flat feet can occur in children with a variety of symptoms. Flat feet is a term for foot deformation from hyper pronation caused by loss or immaturity of the medial longitudinal arch. Flat feet are classified into pathologic flat feet with various primary causes, and physiologic flat feet without the development of the medial longitudinal arch. Flat feet in children are usually physiologic flat feet. They are found in about 90% of children under the age of 2. This article will cover the use of custom made orthotics for children's flat feet.
According to a research by the Inje University Ilsan Paik Hospital, Goyang, Korea, flexible flat feet, the medial longitudinal arch will vanish when the patient supports his own weight. The medial longitudinal arch will appear when the patient stands on his toes or heels, although in rigid flat feet, it remains low regardless of girth.
Table of Contents
What Causes Flat Feet?
Classification of Flat Feet
What’s the Treatment?
Are Custom Made Orthotics good for children's flat feet?
Effects of Using Custom Made Orthotics for Flat Feet
3D printed orthotic devices for flat feet
What Causes Flat Feet?
Current Opinion in Pediatrics claimed that Pediatric flat feet can be anything from the non-painful flexible normal form of growth to stiff or painful manifestations of tarsal coalition, collagen abnormalities, neurologic diseases, or other underlying conditions. Most children with flexible flatfeet do not show any symptoms and do not require treatment. Custom made orthotics for flat feet, osteotomies, or fusions may be considered in symptomatic children. Arthroereisis has grown in popularity in Europe but is not widely used in North America.
Classification of Flat Feet
According to Transilvania University Press, the height of the longitudinal arch, the valgus of the calcaneus, the height of the navicular bone, etc., are all aspects of flat feet classified in several studies, but the classification most commonly used is that that divides flat feet into flexible and rigid.
When body weight is applied to it, the first type of flattening occurs (a feature that diminishes after this force is removed, the plantar arch returning to its initial shape).
Atik and Ozyurek argue that the specific rigidity of this type of flat feet is present from birth, with symptoms beginning at the end of the first 10 years of life, and is based on various causes (coalition of tarsal bones, congenital vertical talus, spasm of the peroneus muscles, which need urgent diagnostic and therapeutic intervention).
Logically, as in any system, the function of every component determines its entire function, as a whole. In line with this logic, the function of the foot as a whole presupposes coordination, complementarity and association between the actions of all segments that compose it, which is why the modification of a single segment could potentially cause postural reactions in other segments, even inside the foot, as a whole. However, although many papers converge toward the clear manifestations of flat feet at certain ages, there is still no clear international consensus in regards to a standard assessment and measurement framework for flat feet in children. Even though it was proven that in the first 10 years of life pediatric flatfoot is assessed by using certain norms, at a worldwide level the experts still do not agree how flat the foot should be in those years. This approach causes difficulties in the differentiation between the normal and the pathological variant of flat feet. The researchers studied for this paper offered guidelines for measurement, various theories, assessment approaches and relevant scientific arguments, however, it is still not possible to delineate a common line for standardization in regards to measurement and assessment. Most studies were also influenced by the method used to diagnose flat feet by the clinician, which leads to disparate values in regards to the prevalence of flat feet in children.
Treatment: Custom Made Orthotics for Children's Flat Feet
Based on a research study about using custom made orthotics for children's flat feet performed by Prosthetics and Orthotics International, flexible flat foot patients who attend the prosthetics and orthotics units are prescribed arch support by orthopedic surgeons. For treatment, a pair of thermoformed plastic inserts are usually manufactured and fitted. To examine the immediate effects of the custom orthotics for flat feet treatment, a motion analysis system was used, which included two video cameras placed on the lateral and rear sides of the subject and a force platform.
Eight subjects with an arch index (AI) greater than 3.O were involved in the study, and three successful steps on the force platform were videotaped for each subject in both shod (shoe only) and orthotic (shoe and orthosis) conditions. The kinetic variables were normalized to the subjects' individual body weights and averaged. A Paired t-test was used to calculate sample means of matched pairs between the shod and orthotic conditions.
The modified UCBL shoe insert (A UCBL foot orthosis (UCBL) is a rigid, plastic, arch support designed to correct the position of your foot. It is called a “UCBL” foot orthosis because it was developed at the University of California-Berkeley Lab.), when tested, significantly altered the orientation and movement of the subtalar joint, ankle joint, and knee joint. These immediate effects reduced the severity and duration of abnormal pronation during the stance phase and thus had the potential to decrease strain on the plantar ligaments and abnormal tibial rotation, both of which could prove beneficial for the foot.
Are Custom Made Orthotics Good for Children's Flat Feet?
As stated by Lower Extremity Review, for individuals with FFF symptoms, the custom made orthotic prescription for flat feet is currently recommended to control excessive motion of the lower extremity during running. The reason orthotics for flexible flat feet individuals are designed to control motion during running is due to the greater forces encountered while running, which can cause more motion and injuries/pain. There is broad consensus in the literature about the clinical effectiveness of custom orthotic interventions among runners, in particular the positive associations with patient satisfaction and pain relief, which enables individuals to resume running.
Currently, researchers are attempting to understand the mechanism by which orthotics produce these encouraging symptomatic reductions. It has been speculated that orthotics may realign the lower extremity, decreasing the excessive motion of the rearfoot and tibia that is typically seen among individuals with FFF. Therefore, it seems that every study indicates a positive mechanical effect of orthotics in reducing excessive motion of the lower extremity.
Effects of Using Custom Orthotics for Flat Feet
According to a related study, after wearing custom made orthotic insoles with medial heel skive technique for six weeks, the foot and ankle function scores in ADL increased significantly from 83.73 to 98.25 and the proportion of these functions increased from 76.11% to 96.5%, according to the results of using custom made orthotics for flat feet. The SPORT function (activities with a higher difficulty rating) scored significantly increased from 77.63 to 95.11, while the overall percentage of these functions given by individuals increased from 70% to 92.06%.
Initial reports of foot function were normal among 22.22% of the research participants, while the rest reported near normal and abnormal levels of function in 55.56% and 22.22% of the participants after six weeks of using the orthotic insole. After six weeks, nearly normal results were reported by 5.56% and normal results by 94.44% of the participants in this study. Also, this technique could be used to assess physical function.
3D Printed Orthotic Devices for Flat Feet
On the report of BMC, in podiatry and the footwear industry, an accurate geometrical description of the foot shape is required for creating custom made orthotics and footwear for different types of people, including health workers and athletes, and patients with foot or lower limb disorders. The medial longitudinal arch, the most distinctive morphological characteristic used to characterize the foot type, allows the foot to behave like a spring: when loaded vertically, it stores energy in several visco-elastic structures, such as the plantar aponeurosis, which can be returned via elastic return.
Flat foot, particularly, has long been a major health concern for people around the world and has been linked to their sedentary lifestyle in the past. Zero activity, excess weight, prolonged sitting, and standing are the main causes of foot pain even among people with normal arch width. People in the 60-65-year-old age range are most susceptible to flat feet. Because of their lifestyle, people in the middle age group of 40–60 years have also developed this condition. In the past few years, some people in younger age groups have developed flat foot problems. In most cases, custom made orthotics help with children's and adults flat feet problems.
Confirming to Sciencedirect, doctors have suggested physical exercises, pharmaceuticals, and custom made orthotics for flat feet to address the problem. Common orthotic aids include insoles, cushions, massage pads, and medical shoes. The use of orthotic aids provides relief to the foot. By injection molding, silicon material is most often used for the production of orthotic aids. On the other hand, some people report feeling uncomfortable while using these devices, so to solve the problem, an attempt is made to develop an alternative to traditional orthotic aids. The goal was to design and develop a 3D printed orthotic aid that improves foot alignment in the lower limbs and offers relief from common foot problems, which included optimizing the design through analysis and manufacturing using 3D printing.
“Flatfoot (PEs planus) is an ailment that usually resolves by the age of adolescence. Flatfoot is therefore referred to as physiologic because it is generally flexible, painless, and of no practical value. Flatfoot can become painful or rigid in rare cases, which could be a sign of more severe foot conditions, such as arthritis or tarsal coalition. Despite its prevalence, there is no standard definition for the pediatric flatfoot.
Custom foot orthotics can provide relief of pain when present.” American Academy of Pediatrics claimed.
Dr. Matt Ahmadi,Custom Orthotics OC's Owner, provides customers with the most suitable orthotics using the 3D scanning and contact less method for their convenience and satisfaction plus offering cost-efficient custom made orthotics for children's flat feet in Orange County.