Flat-footed thirty-something
November 23, 2020 4:53 AM   Subscribe

I'm in my thirties and have flat feet. I have just never really bothered to go to a doctor about it. But I'm starting to worry about the long-term effects. Who do I speak to about this, and what might the options be?

I've had fallen arches/flat feet since I was a kid. It hasn't bothered me too much over the years, apart from wearing out shoes quickly, but in the past few years I've noticed some knee and hip pain which I think might be being caused by my flat feet. I'm also quite unsteady when walking on slippy surfaces.

What type of doctor would I go to in order to discuss this, and what might they say to me? Do you have any experience with this? Thanks very much!
posted by iamsuper to Health & Fitness (7 answers total) 1 user marked this as a favorite
A podiatrist.

When I was a kid before my bones fused a podiatrist helped me get special inserts. Because you're 30 and your foot bones are fused, you'll probably need something else, but I would still start there!

You probably need a reference from your normal doctor first
posted by bbqturtle at 5:10 AM on November 23, 2020

You're in Europe so it might be a little different than things are here (Canada) but I would tackle this like so:
  • Your feet may or not be the problem - either way I'd start with a physiotherapist. You'll be wanting to have a few visits, get some screening as well as some xcercise looking at your whole posterior chain. ie: walking, balance and stability require posture, control and functional movement in most of the joints in your body. If you have a "chin forward" posture your balance will be different. If you have weak(er) hips your lateral stability will by compromised. This is he place to check where you stand now and get first recommendations for amelioration.
  • Have your doctor consult with the physio and decide if you need meet with anyone else. Stability & walking, nothing issues with similar Activities of Daily Living (ADL) are common flags to check for rarer neurological conditions particularly when they present without growth or an acute trauma
  • Then I'd take their recommendation for adaptive footwear be it insoles, prosthetics etc. The quality and helpfulness of which can vary; you will probably want a personal recomendation/referral. This should probably include a consult with a podiatrist.
All this being said - I am not a doctor, physiotherapist or other healthcare practitioner. I am certainly not you practitioner. I do work everyday with athletes who come to me with a wide array of impairments (it's in the very nature of what I do) but that does not make me endow me with any particular clinical expertise. These would be the steps I would recommend to one of my adult athletes who noticed a change so that I could better do the job I am qualified to do.
posted by mce at 5:16 AM on November 23, 2020

Amplifying mce’s performance/ functional movement perspective as *part of* a solution.

In athletes (do you move? Congrats, you might be an athlete), all of the leg is connected, and looking at their movement patterns as a whole might resolve hip, knee and foot at the same time.

I know for me personally, all of my knee ankle arch pain was related to weak weak hips and sitting around all day. I had poor internal and external rotation, bad proprioception and patterns. The pain was a result of those weaker muscles and joints compensating.
posted by gregglind at 7:02 AM on November 23, 2020

I'm a 44 year old flat footer. At age 37 I started running, and as gregglind mentions the foot/leg/etc are all connected. My lower legs pains have all been because of weak hips/glutes (due to being a professional sitter). But stepping back, I'm a middle aged flat footed person, and I've run hundred milers / 24 hour races. Excluding some blisters, my feet have never been a problem. I've never had to quit a race because of blisters. I.E. flat footed isn't necessarily a problem.

If you're wearing through shoes faster than normal, that sounds like a gait issue (scuffing your feet, excessive suppination/pronation, possible balance issues, etc). As you actually have some hip/knee pain, I'd echo the suggestion to see a physiotherapist. Some may make recommendations to podiatrist if that's your problem, but again being flat footed isn't necessarily a problem, so don't be surprised if the physio gives you some balance/strength work.
posted by nobeagle at 7:49 AM on November 23, 2020 [1 favorite]

I'm 39 and have had flat feet my entire life with no adverse results from the flatness specifically, so agree with nobeagle that they may or may not be the problem. But I've had other foot issues off and on over the years. A physiotherapist or podiatrist will be a good place to start. If it were me, I'd start with a physical therapist who can check your shoes, gait, posture, and full range of movement which will almost certainly yield some insights and corrections, particularly since the pain is in your hips and knees and NOT in your feet (if it were, I'd go to the podiatrist first).

Also, this book utterly changed my life. Even though it references women in the title, 95% of it is universally applicable and offers tons of immediately applicable and sustainable guidance around improving your overall foot health, including gait, foot stretches, what to look for when choosing shoes, and so on. I used to have so much foot pain (from a bone issue, unrelated to my flat feet) that I had to get regular cortisone shots and would limp after an easy 45-minute walk. I haven't hurt like that in literally years since I changed the way I purchased shoes. (Oh, and it looks like she's recently published an updated version that's not specific to women.)

Good luck!
posted by anderjen at 12:13 PM on November 23, 2020 [2 favorites]

A couple of years ago I did a bit of research on being flat-footed. (I can't remember why, because I'm not flat-footed.) There's been a lot of work done to cure the condition, and at one point you could be rejected from military service for having flat feet, but there's no evidence that it's harmful or will lead to other problems. It appears to have been one of those things people - and even professionals who should have been more careful - believed strictly because it seemed likely.
The damage done by shoes that don't fit, on the other hand, is terrible. If you're worried about your feet, it's something you should be careful about.
posted by AugustusCrunch at 7:58 PM on November 23, 2020

get shoe inserts. if they squeak, request ones that don't. don't put up with squeaking inserts like I did.
don't wait. they changed my life.
posted by evilmonk at 2:47 PM on November 24, 2020

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