Modern living has produced a virtual epidemic of fallen arches. The good news is that there are many practical solutions to address flat feet.


APRIL 27 2018

First, let’s try to understand how an arch is developed and what could cause a compromise of said arch.

Having a flat foot can stem from improper footwear, as well as difficulties occurring in early childhood. Upright posture is developed over time through our experience with our environment. This is when we learn to develop a sense of where our body is in space and as we move.

As the nervous system matures and the pyramidal tracts gain more control over spinal motor neurons, the plantar response of the foot becomes part of the postural reflex maintaining the muscle tone of the foot and leg. This will be essential later in life for coordinated and controlled gait patterns, as well as for sports proficiency.

The lateral side of the skin of the foot represents a reflexogenic area of the first sacral dermatome. The sensory (afferent) fibers in the skin of the foot in this zone travel to the tibial nerve (which is a branch of the sciatic nerve), to relay information to the L4 – S1 segments of the spinal cord.

The motor (efferent) fibers from the spinal cord then travel back to the sciatic nerve, which is divided into two large branches just proximal to the knee.

Branch 1- Fibers supplying the toe flexors travel in the tibial nerve.

Branch 2- Fibers supplying toe extensors travel in the peroneal nerve to reach the foot.

Testing the foot reflex provides a reliable method for evaluating the integrity of the motor pathways to the lower limb.

The plantar response (in adults) may be:

-Normal flexor plantar response (physiological)

-Extension of the toes (pathological)

-The reflex is elicited by stroking the lateral border of the sole of the foot with a pointy object. The stimulus is directed from the lateral border to the small toe towards the big toe

To test:

1. The patient is supine. Use the handle end of your reflex hammer or pencil.

2.  Start at the lateral aspect of the foot, near the heel. Apply steady pressure with the end of the hammer as you move up towards the ball of the foot (area of the metatarsal heads), from the fifth to the first metatarsal.

3. When you reach the ball of the foot, move medially, stroking across this area.

4. Then test the other foot.

How To Fix it

Another alternative method would be to use neurological exercises, to re-train the brain to integrate a reflex that was not properly integrated. These exercises are different than regular strengthening exercises in that they target parts of the brain than are used to normalize muscle tone and decrease the over-flexibility of the joints.

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