How can I recognise foot malpositions and what types are there?
Have you ever thought about the strain our feet are subject to on a daily basis? Our feet allow us to stand firmly on the ground and move around while keeping our balance. Foot deformities disrupt this interactive process. Although they have very different causes and symptoms, they do have the following in common: left untreated, they can lead to pain and sequelae, for example in the knees, hips, back and neck. Improper positioning of the feet occurs in both children and adults. Improper positioning of the feet is sometimes easy to see, for example when the feet buckle inwards or tilt outwards.
We give you pointers to recognise a possible improper positioning of the feet. Your doctor alone can then make the concrete and correct diagnosis. They will give you appropriate therapy recommendations to effectively remedy the improper positioning of the feet.
A brief explanation of foot malpositions
Valgus foot: the lower leg and the heel normally form a straight line. If the foot arch can no longer hold its original position – i.e. it buckles inwards – this is referred to as valgus foot. Causes include unstable tendons and ligaments, muscle weakness or axial malalignment, such as knock knees.
Fallen arches: the longitudinal foot arch is flattened. The inside of the foot is thus lower than in a correct foot positioning, and sometimes it even rests completely on the ground. This can cause pain. Rare causes include congenital malformations, which lead to problems as early as in childhood, paralysis, weak ligaments and muscles, and obesity.
Pes transversoplanus: a transverse arch flattened in the forefoot is referred to as splayfoot. This area carries most of the weight when you walk, leading to pain in the ball of the foot and toe area. Calluses and pressure sores are typical symptoms. How does pes transversoplanus develop? Causes include in particular: unstable tendons and ligaments, muscle weakness, standing for long periods, heavy lifting, obesity. Shoes that are too tight and too high also promote the development of splayfoot.
Pes planus: Pes transversovalgus refers to different deformities that occur in conjunction – valgus foot, fallen arches and splayed foot. This foot deformity is also commonly known as “flat foot”. If a child’s pes planus does not regress on its own, it can usually be corrected conservatively with foot orthotics and foot exercises. An foot orthotic fitting can also provide adults with support. It provides the necessary soft cushioning, takes the strain off of the forefoot and raises the arch of the foot.
Highly arched foot: The opposite of pes planus is high arch. In this case, the longitudinal arch of the foot is overly high and the forefoot and heel are subject to excessive loads. Pressure marks, calluses and so-called claw toes (an abnormal hyperextension in the metatarsophalangeal joint and increased flexion in the metatarsophalangeal and distal joints) can occur as symptoms. High arch can be either congenital or acquired; possible causes can be muscle balance disorders (weaknesses or paralysis).
Pigeon toe: Usually occurs on both sides and is common in babies. In this case, the forefoot deviates inwards, resulting in a foot with a curved shape. Pigeon toe can be either congenital (positional due to the narrowness of the uterus) or acquired (when the infant is in a preferred prone position). Pigeon toe is generally easy to correct.
Pes equinus: Pes equinus is characterised by an elevated heel due to an abnormal flexion of the foot in the ankle joint. Obvious symptom: as affected persons are unable to set the entire sole of their foot down, they walk on their “tiptoe”, so to speak. This improper positioning of the feet can be either congenital or acquired. Possible causes include severely shortened calf muscles, muscle diseases, bony changes in the ankle joint or scars.
Prevention: Preventing foot malpositions
Preventing improper positioning of the feet as early as in childhood is better than any correction. Walking barefoot is the best preventative measure. Good shoes likewise significantly promote the development of healthy feet. For example, wearing shoes that are too small may result in foot deformities with lifelong consequences. A lightweight shoe with a flexible sole for dynamic rolling over is ideal. It is also important to have enough space between the shoe and the toes.
Foot exercises: exercises for pes transversoplanus, pes planus, high arch, pes equinus and pigeon toe
Special exercises are very suitable for strengthening the muscles and promoting the mobility of the feet. Please consult your doctor.
Toe caterpillar
Agility, activating the transverse arch – toe caterpillar
Lay half a tennis ball on the floor. Claw your toes in the floor and drag your foot in the direction of the ball. When your foot is by the ball, shoot it a little forward with your toes. Repeat many times and then use the other foot.
Tearing up newspaper
Coordination, agility – tearing up newspaper
Spread out a piece of newspaper on the floor. Stand with one foot on the paper and try to tear it up with the other foot. Then change the foot.
Picking up marbles
Coordination, agility – picking up marbles
Put a few marbles (or similar objects) on the floor. Try to lift them up with your feet and put them in a container. Change feet every time you successfully lift up a marble.
Foot massage
Loosening, relaxation – foot massage
Put a hedgehog or fasciae ball on the floor and massage the soles of your feet in circular movements.
Stretching your calves
Stretch – stretching your calves
Support yourself against a wall, put one leg behind the other and stretch your calves. While doing this, the heel of the leg at the back should not leave the floor.
Insoles for foot deformities
If it is necessary to treat improper positioning of the feet in children and adults orthopaedically, foot orthotics can be a good choice. A flexible carbon shell in combination with freely placeable support elements – so-called “postings” – enables a specially tailored fitting for splayfoot, valgus foot, fallen arch, high arch and pigeon toe: the carbon shell is particularly light, flexible and adapted to natural movement patterns. Although the foot is guided its movement is not restricted. The postings can be precisely positioned. They stabilise the foot statics while giving the foot ample freedom of movement.
You can find a selection of our premium carbon foot orthotics here.
Especially for pes planovalgus (combination of skew foot and fallen arches), treatment with the supportive bow foot orthotic, which imitates the natural windlass or winch mechanism can be sensible. This ensures that the longitudinal arch straightens up once the toes bend or are lifted. This stabilises the foot during the execution of the step.3 This mechanism is disrupted in pes valgus. bow® straightens the midfoot and rear foot, thus stabilising the arch of the foot. This foot orthotic also promotes the natural direction of movement throughout the entire load phase.
Find out more information about our orthopaedic insoles for the rehabilitation of incorrect foot positioning here.
Ask for advice at your medical supply store. The orthopaedic shoe technician custom-fits the insole.
Highlights
Product tip
Diagnosis & treatment
Sources:
1 Jeder Schritt zählt. Ärzteblatt.de. (Last access: 23.07.2021).
2 Einlagenversorgung. Ein Informationsbuch der eurocom e. V. Internetversion. S. 19 ff. (Last access: 16.7.2021).
3 Schwering L. Die Plantaraponeurose und der Seilwindenmechanismus des Fußes. Orthopädieschuhtechnik 2016;16(2):20–23.
Health personnel will make the diagnosis and can prescribe medical aids, e.g. from medi if necessary.
Your medical retailer will fit them individually for you.
