Quick overview:
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
Pes valgus (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 (splay foot)
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 transversovalgus (flat foot)
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.
Pes cavus (highly arched foot)
The opposite of pes transversovalgus is the highly arched foot. 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.
Find out more about the most common foot malpositions in adults and children.
Foot malpositions in children must be taken seriously, as they can impair well-being, mobility and development. Therefore, please look out for the signs listed below.
Take your child to a paediatric orthopaedic practice if
- they experience pain while walking,
- foot malpositions exist or
- a neurological condition has been diagnosed.
Furthermore, “childhood flat foot” and pes planus can often occur at a young age. As children grow, this usually corrects itself with good shoes and lots of barefoot walking. In the first few years, children’s feet therefore usually do not need treatment, unless there is a special indication and the child is in pain. In such cases, children’s foot orthotics may be necessary before the age of six and can also achieve good therapeutic results. If the fallen arches persist after the age of six, foot orthotics can provide gentle correction.
Orthopaedic foot orthotics for children
If you notice signs and symptoms in your child that indicate foot problems, a medical diagnosis is essential. If necessary, your child will then be prescribed orthopaedic foot orthotics. These can support, cushion and correct children’s foot malpositions if they are fitted correctly and checked regularly.
Please note that children need a certain amount of time to get used to new foot orthotics. After two to four weeks at the latest, the little ones usually get on very well with them. If not, the fit and positioning in the shoe must be checked again by a specialist.
Foot orthotics for children: freedom of movement and comfort
- Growth: children’s feet are constantly growing. This is why regular checks by the supplier and the doctor are important. Depending on the type of orthopaedic foot orthotics, they may need to be adjusted to the new requirements or, if necessary, replaced with larger foot orthotics. The doctor can then issue a prescription for new foot orthotics.
- Comfort: children are usually very active and therefore need foot orthotics that allow them sufficient freedom of movement. Foot orthotics made from modern materials are lightweight, flexible and yet stable. They provide support with a high level of wearing comfort. This is crucial, because if a child finds their foot orthotics uncomfortable or pressure points form on their feet, they will not want to wear the foot orthotics. Adaptation to everyday life: the foot orthotics should also be easy to integrate into the child’s everyday life. The choice of suitable shoes is also very important for this.
Prevention: avoid foot malpositions as early as childhood
Foot malpositions can be prevented as early as childhood. The best remedy is to walk barefoot. Good shoes also have a major influence on the development of healthy feet. For example, wearing shoes that are too small can cause malpositions that can have permanent consequences. A lightweight shoe with a flexible sole for dynamic rolling is therefore ideal. Sufficient space between the shoe and toes is also important.
Targeted training in cases of foot malpositions such as pes transversoplanus, pes planus, pes cavus, pes equinus and pes adductus
In cases of foot malpositions, special exercises are very suitable for strengthening the muscles and promoting the mobility of the feet. Please get medical advice.
Exercises for foot malpositions
Exercises for children with foot malpositions
For children too, it makes sense to accompany the therapy with special exercises for foot malpositions.
Foot orthotics 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 foot orthotics for the rehabilitation of incorrect foot positioning here.
Ask for advice at your medical supply store. The orthopaedic shoe technician custom-fits the foot orthotics.
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.
