FootNotes : Are Flat feet, evolution for sedentary?

Guilty I am of posting after a ridiculously long break. Life gets busy and sometimes there is no way out. Well this time off, got me to a few realizations. Few Crazy ones. I am going to talk about my First realization or rather discovery as you might have guessed from the heading. Evoluntion-ary Flat Feet.

After having worked in a Sports Speciality clinic in Boston under a Physio
therapist who specializes in Orthotics. I learnt my bit about foot. Since quite a while, I have been noticing that almost 70% of my patients with Back, Knee, Ankle problems sometimes even Shoulder pain have Flat foot or feet to vary-ing extents.

 I also work with an Tennis Academy for Injury Prevention and Performance Enhancement. I have around 20 Kids, all Advanced players, with 60% of them having Flat
foot/feet.

Research shows Children with a flatter foot posture are more likely to have pain or discomfort at the knee, hip and back; however, the mechanisms by which this occurs remain unclear. Ref: Are flexible flat feet associated with proximal joint problems in children? 2016

As more and more research pour in, links between knee, hip,   back, shoulder and flat feet are being established. But, the question is, ” why is the rise of flat feet in our population??”

Lets dwell into the world of foot and its arches to understand this better. You have 3 arches in your foot. The Medial  longitudinal arch (MLA) is the one on the inside of your feet. When the medial arch drops its called flat foot/ flat feet/ pronated feet. Research indicates that the arch is held together by the plantar aponeurosis, Spring Ligament, the intrinsic foot muscles and other supporting ligaments and muscles.

The Function: Why do we have the MLA? Think Archery, Just like you use a bow to propel an arrow forward. Our bodies use the Plantar Aponeurosis, the spring ligament and the support structures to propel us forward while walking and running. During the stance phase ( single leg standing) of walking, as the foot comes in contact with the ground, the MLA arch compresses causing slow lengthening of all the tissues around and the energy gets stored in. Just like when you pull an arrow backward on the bow before propelling it.

As soon as you start moving forward on the leg, this bow comprising of MLA and the structures maintaining it recoils propelling you forward. Same happens in Running although at higher peak recoils due to greater impacts on the ground.

Why should a collapsed arch bother this mechanism? A collapsed Arch is like a Bow which does not have enough tension. Due to lack of tension, the body is unable to use it to propel itself forward effectively bringing in muscles and straining ligaments and bone structure. Moreover, our ankle is stacked on top of our foot. Collapse in the MLA would cause that stack to collapse locking up the knee joint and causing alterations in the kinetic chain moving proximally.

Walking and Running with a collapsed arch in long term will lead to numerous issues with various other joints in the kinetic chain. And thats why rising number of people with flat feet scare me and should scare you too.

The arches are used for propulsion during running and walking. Sedentary lifestyle  has caused a major change in the way we use our feet. We are sitting more time than we are moving around. The exact opposite of what we did centuries ago. As Human Race underwent evolution we moved from ape like feet with opposing thumb to  well developed arches with inline thumb to help us run better and walk better.

Evolution takes years of minor changes to amount to one major change. Numerous years of sedentary lifestyle will eventually lead to us to losing our propulsion mechanisms, our arches..  compare the foot print of Neanderthal man with that of 3rd degree flat feet. Looks Similar Doesn’t it ?

Are few steps forward a giant leap back ward for Human Kind?

Signing off for now, with thoughts you need to ponder on!!!