For many a long time, if not centuries, researchers, doctors, and the general public have believed that folks with flat feet are more prone to various problems.
In particular, flat feet were thought to predispose to future pain and other musculoskeletal (i.e. muscles, tendons and/or ligaments) problems.
It was believed that flat feet were a sort of time bomb.
However, in A latest editorial published in the British Journal of Sports Medicine, my research team debunks this myth. We show that the theory that flat feet inevitably result in pain or other musculoskeletal problems is unfounded.
As a researcher in podiatric medicine at the Université du Québec à Trois-Rivières (UQTR), I’ll explain here the primary findings of our study.
Where does this theory come from?
The concept that flat feet are an issue goes back centuries.
It was revived in the second half of the twentieth century by American podiatrists Merton L. Root, William P. Orien and John H. Weedwho popularized the concept of “ideal” or “normal” feet.
These clinician-researchers were the first to propose that if feet didn’t meet certain criteria for normality (e.g., well-defined plantar arch, straight heel consistent with the tibia), they were abnormal, less efficient, and more prone to injury. injury on account of multiple biomechanical compensations, akin to greater flattening of the arch during walking.
This theory has grow to be a central element of health care skilled educational programs. Although today the theory is regularly disappearing as modern curricula are updated, the theory was taught around the world for nearly five a long time, although the scientific basis was weak. In fact, science has never confirmed this theory: it remained at the stage of hypothesis.
Nevertheless, over the years and as much as the present, many health care professionals have continued to support the theory that flat feet represent a significant risk for developing musculoskeletal diseases.
As a result, the idea continues to be firmly entrenched in the beliefs of the general public.
Do flat feet cause musculoskeletal injuries?
Contrary to theory Root et alMeta-analyses, which represent the highest level of scientific evidence, have found no increased risk of developing the overwhelming majority of musculoskeletal injuries in individuals with flat feet.
These meta-analyses identified only weak associations between flat feet and the risk of medial tibial stress syndrome (pain in the shin bone), patellofemoral syndrome (pain around the kneecap), and nonspecific lower limb overuse injuries.
That’s it.
Moreover, a systematic review ia meta-analysis showed that runners with flat feet aren’t any more susceptible to injury than runners with normal feet.
These analyzes call into query the idea that folks with flat feet are at significant risk of developing musculoskeletal diseases.
However, despite these findings, various sources akin to gray literatureskilled web sites, forums and other media often suggest that folks with flat feet are at higher risk of injury and even require treatment – even if they haven’t any symptoms.
Unfortunately, this often leads to the need for unnecessary interventions, akin to the use of orthopedic shoes or custom-made foot orthoses for asymptomatic flat feet. This also results in significant concerns amongst patients about the appearance of their feet.
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Equalizing the record
Asymptomatic flat feet generally don’t require intervention from medical personnel. Based on current scientific knowledge, assessing whether an individual has flat feet to find out risk of injury is ineffective and counterproductive.
Although an individual with flat feet may experience a musculoskeletal injury, this doesn’t necessarily mean that the flat feet caused the injury.
It is sort of possible for 2 variables to occur concurrently with no causal relationship. There is a crucial difference between causation and correlation. A cause-and-effect relationship assumes that a change in a single variable (cause) results in a change in one other variable (effect). When two variables are correlated, changes in a single variable could also be related to changes in the other, but this doesn’t mean that one causes the other.
To illustrate this idea, let’s take the following example: We give 500 children between the ages of six and 12 the same math test. When conducting correlation tests, we notice an inclination: the larger the kid’s feet, the higher the final exam grade.
This begs the query, does foot size actually affect math skills? Of course not!
Another variable that just isn’t taken under consideration plays a crucial role on this correlation, namely age. Since feet get larger with age, there may be a robust, yet spurious, correlation!
The same rule applies to flat feet. If an individual with flat feet develops a musculoskeletal injury, current research indicates that flat feet will not be necessarily the cause and that other aspects ought to be investigated.
The relationship is correlation, not cause and effect.
Reducing overdiagnosis in health care
Reducing overdiagnosis in healthcare has grow to be crucial. This phenomenon, defined as the diagnosis of a medical condition that has no net individual profit, represents a world burden and could have adversarial effects on patient health. Physical, psychological and financial well-being.
From a financial standpoint, it is easy to grasp that prescribing custom-made foot orthotics costing a whole lot of dollars to stop musculoskeletal injuries related to asymptomatic flat feet has a big negative impact. This is particularly true considering that the presence of flat feet only barely increases the risk of those injuries.
To address this issue, health care providers must help reduce the overdiagnosis of flat feet by more clearly distinguishing for patients between harmless anatomical variants and conditions which may be of concern.
Since overdiagnosis often results in overtreatment, avoiding unnecessary procedures will help alleviate patients’ concerns about flat feet.
Finally, we want to desert the outdated, still common belief that flat feet are an issue that puts people at high risk of musculoskeletal injuries. It’s time to alter your perspective and approach to the importance of flat feet and recognize their natural diversity in the context of overall foot health.
First of all, it is time to think about asymptomatic flat feet for what they’re… just an anatomical variant!