Are Flat Feet A Problem?

Written by Bianca Charles on June 26, 2020

Last updated March 7, 2024

About 30% of the population live with flat feet.

So there’s a high likelihood that either you or someone in your family have flat feet.

What Are Flat Feet?

Flat feet are as they sound: a collapsed arch with much of your sole in contact with the ground. This is relative to a regular arch, which is when about half of your arch is in contact with the ground.

Good news! Flat feet are usually a painless condition. Often, flat feet occur during childhood development, but they can also occur as you age. Flat foot often starts with a dysfunction of the ankle tendon known as posterior tibial tendon. This tendon is responsible for holding up your arch. Weakness or underdevelopment in the tendon means your arch can drop.

Injury to the ankle can also cause flat feet, partly because damage to the tendons won’t be able to support your arch.

How Can I Tell If I Have Flat Feet?

The easiest way to determine your foot type is with a wet test.

The wet test is a cheap and easy way to determine your foot type. The test only requires a piece of paper and wetting the bottom of your foot.

To perform the wet test:

Pour a thin layer of water into a shallow pan
Wet the sole of your foot
Step onto a blank piece of paper (or onto a wooded surface like your deck)
Step off and look down

Based on the shape of your foot on the paper, you can determine your foot type. If your arch is partially filled out, then you have a normal arch. An arch that’s fully filled out means you likely have flat feet and fallen arches. If your arch is barely visible, you likely have a high arch.

Is It A Problem?

In short: it depends. In most instances, it isn’t.

There are generally a few tendencies associated with flat feet.

People with fallen arches generally have more inward rotation than those with a regular arch.

Generally, this gait deficiency will overwork other muscles and tendons in the leg. Overcompensating in your lower leg can cause problems in your knees, ankles, and hips. Fallen arches can also cause pain in your arches and can lead to swelling. Overcompensation can also lead to underlying issues in the foot like bone spurs, osteoarthritis, and bony prominences.

Someone with flat feet may also experience posterior tibial tendonitis. This condition causes pain and swelling in the posterior tibial tendon. As the tendon supports the arch of the foot, and provides stability, leaving this condition untreated may lead to an increased risk of flat feet. Why? Since the resulting tendons become inflamed and damaged, they lose the ability to maintain your arch height.

In many cases, the body adapts to having flat feet and you may never experience pain at all.

One form of fallen arches is known as flexible flat feet. In these cases, you never develop symptoms and the fallen arch is related to the looseness of ligaments and is inherited. In this case, flat feet are not preventable.

How To Live Pain-Free With Fallen Arches

If you’re pain-free, no treatment is necessary.

However, just because you don’t have pain now doesn’t necessarily mean you won’t in the future. Given your body may compensate for fallen arches, the deficiencies in your stride may take years to develop. (On the other hand, the deficiencies may never develop into pain.)

If you do start to experience pain, there a number of measures you can take including:

Orthotics: custom foot orthotics are specifically designed for your feet. These devices work to correct faulty foot mechanics and redistribute pressures across the bottom of the foot.
Motion Control Footwear: to help with overpronation (when your foot rolls too far inward), motion control footwear has medial support built into the midsole to help limit the damage and wear to the inner portion of your shoe.
Lifestyle Changes: an exercise program and a plan to manage your weight can help reduce the pressure on your feet.
Stretching Exercises: stretching and lengthening the range of motion of your Achilles tendon can help.

In short, flat feet can pose some problems in certain cases. In many cases, they aren’t a problem, especially if you follow certain precautions like strengthening and orthotics.

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Everything You Need for Healthy Feet - All Under One Roof

At Feet First Clinic, we’re always excited to welcome new clients! We’re Toronto’s one-stop-shop for all your foot-related needs. For 15 years, our staff and licensed chiropodists have been helping people with their feet. From foot care to foot pain to foot products – we do it all! Give us a call to ask our friendly staff any questions you may have! Our Toronto foot specialists are ready to help!

Call us at 416-769-3338 or Book Your Assessment Today!

About Author: Bianca Charles

With 15 years of dedicated experience in podiatry, Bianca Carter offers a wealth of knowledge and expertise at Feet First Clinic. Throughout her career, Bianca has worked closely with leading chiropodists, continually deepening her understanding of all aspects of foot care.

Learn more about Bianca Charles

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April 24, 2025

Top Stability Running Shoes

If you’re dealing with flat feet and overpronation, or sometimes other foot issues, finding the best stability running shoes can provide the support and comfort you need. These shoes are designed to help keep your feet properly aligned and reduce strain, making them perfect for running or everyday wear. In this guide, we’ll help you find the right pair and keep you moving with a little more peace of mind. What are Stability Shoes? https://www.youtube.com/shorts/TnDaLrqYTac To understand what stability shoes are, it’s important to explain the different foot types and the corresponding, suitable shoes that accommodate each type. Foot types are characterized by how pronounced the arch is, as well as any associated gait abnormalities (walking patterns): Flat feet: When you have a minimal or non-existent foot arch, or when your footprint looks like a complete foot. The foot rolls excessively inward when it’s in motion (overpronation). It is often linked to the development of plantar fasciitis. High arches: When your arch is very pronounced and you see very little of your footprint. Sometimes associated with underpronation, or when the foot rolls excessively outward when it’s in motion. Normal arch: When your arch is about halfway “filled” when you look at it from a footprint perspective. There are generally no issues with overpronation or underpronation. Why Stability Shoes? Think of stability shoes as running shoes for flat feet. They are specifically engineered to help people who overpronate, providing enhanced support and alignment during movement. They are more rigid, rather than flexible, to ensure the foot stays securely in place when it propels forward. That said, thanks to technological innovation, many stability running shoes on the market offer the necessary correction without feeling restrictive. More specifically, unlike neutral running shoes (which tend to be more flexible and are suited for those with a normal gait or high arches), stability shoes guide the foot into a more neutral position. This is achieved through features like firmer midsoles and supportive arch structures that counteract the inward rolling motion characteristic of overpronation. By doing so, stability shoes help distribute pressure more evenly across the foot, reducing strain on muscles and ligaments. This design not only improves comfort during activities like walking or running; it also plays a crucial role in preventing injuries commonly associated with overpronation, such as plantar fasciitis and shin splints. If you have severe overpronation, motion control shoes offer an even higher level of support. These shoes are constructed with stiffer materials and additional structural components, such as reinforced heel counters and medial posts, to limit excessive foot movement. While some motion control shoes may feel heavy, they provide maximum control, ensuring the foot maintains proper alignment throughout the gait cycle. This level of control is particularly beneficial for those who require substantial correction to prevent overuse injuries. Motion control shoes can significantly reduce the risk of pronation-related injuries in recreational runners and can be an effective injury prevention strategies. How Do Stability Shoes Prevent Foot Pain? Stability shoes help prevent foot pain by offering targeted support where your feet need it most—especially in the arch and heel areas. When your foot rolls too far inward, it puts extra strain on the muscles, tendons, and ligaments that work to keep your stride in check. Over time, this can lead to discomfort or injuries like plantar fasciitis, shin splints, or achy knees. Stability shoes are designed to keep that motion in check, gently guiding the foot to move in a more efficient and aligned way. This takes the pressure off the wrong areas and helps absorb shock more evenly across your foot. Another key way stability shoes help reduce foot pain is by minimizing the stress placed on your body with every step. Features like firm medial support and structured cushioning help maintain better posture and balance, especially during long walks or runs. That added support means your feet aren’t constantly working overtime to stabilize themselves, which can help you stay active longer without feeling sore. At the end of a long day, your feet will thank you! The Best Stability Running Shoes Where do you start when you want to find the right pair? Luckily, we’re going to talk about some of the best options. Some of these are available at our Toronto foot clinic, Feet First Clinic, and come highly recommended by chiropodists and podiatrists. You can always call or visit us to determine what high quality footwear we have in stock at any given time. ASICS Gel-Kayano 32 The ASICS Gel-Kayano 32 is a go-to for runners seeking plush support and a smooth ride. This latest version keeps the high-level stability the Kayano line is known for, while dialing up the comfort with soft cushioning and a breathable upper. It’s ideal for daily training or long runs when your feet need some extra TLC. If you're browsing for the top running shoes for stability, the Gel-Kayano 32 should be on your radar. It contains ASICS' 4D Guidance technology. This features a "pod" that acts as a medial post to control the movement of the foot and ankle and prevent overpronation. The medial post is made of a responsive material that will respond to your foot's motion and prevent over-correction. In addition, unlike other stability models with a stacked heel, the Gel-Kayano is structured to "cradle" the foot. This gives all cushioned benefits of a stacked heel and mid-rocker sole, without compromising stability and balance. Whether you're logging serious miles or just want a reliable everyday trainer, this one's a solid pick. Saucony Hurricane 24 The Saucony Hurricane 24 is a max-cushion stability shoe built for comfort and support. It features a plush PWRRUN PB midsole and a wide base that keeps you steady, even on longer runs. The shoe is a bit on the heavier side compared to other shoes, but it delivers a smooth, stable ride that's easy on the legs. For those looking for Stability running shoes for overpronation, the Hurricane 24 is a standout option. It provides excellent support without feeling too rigid, making it great for runners who need a bit more structure. Just keep in mind that it's not the best choice for speedwork due to its weight. ASICS GT-2000 The ASICS GT-2000 is a reliable stability shoe that offers a balanced blend of cushioning and support. It's designed for runners who need moderate stability without sacrificing comfort. The shoe provides a smooth transition from heel to toe, making it suitable for daily training. While it may not have the plushness of the Kayano, the GT-2000 is a versatile option for runners seeking a more responsive feel. It's a solid choice for those who need an athletic stability running shoe that doesn't feel too bulky. Brooks Glycerin GTS The Brooks Glycerin GTS is a max-cushion stability shoe that combines softness with support. It features Brooks' GuideRails technology, which helps keep your stride aligned without being intrusive. The shoe offers a plush ride that's perfect for long runs or recovery days. If you're looking for a stability shoe that doesn't skimp on comfort, the Glycerin GTS is worth considering. It's designed to provide a smooth, cushioned experience while still offering the support needed for overpronators. Just be aware that it's more suited for easy runs rather than speed sessions. https://www.youtube.com/shorts/mxrb9Qihtiw

March 27, 2025

How Tight Calves Affect Your Body

Tight calves and foot health go hand in hand (or should we say foot in foot?). Our body parts are intricately connected, meaning discomfort in one area can lead to issues elsewhere. Likewise, muscle strain and fatigue in the lower legs can wreak havoc on the feet and other body parts if ignored for too long. Let’s explore the symptoms and causes of tight calves, how tight calves affect the body and feet, and how a chiropodist or podiatrist can help you manage pain. Tight Calves: What Are They? "Tight calves" is a general term describing the sensation of stiffness, pain and tension in the muscles at the back of the lower leg, often leading to restricted movement that affects your daily life. This tightness can manifest as muscle pain and stiffness when walking, balance issues, and more. Tight calves and posture even have a connection! Anatomy of the Calf Muscles The calf comprises two primary muscles: Gastrocnemius: The primary or chief muscle in the calf. It’s located on the back of your leg, relatively close to the skin’s surface. This superficial muscle has two heads, medial and lateral. It helps flex the knee and foot, and also plays a crucial role in walking and posture. Soleus: Located beneath the gastrocnemius, this wide and flat muscle is deeper, and originates from the posterior tibia while connecting to the Achilles tendon above the heel. This group helps stabilize ankle during activities like walking and running. Understanding the structure and function of these may be helpful in determining the cause of calf muscle tension. What Causes Calf Pain? Pain in the lower part of the back of the legs does not always feel the same. It may come on suddenly, or nag at you all day by way of a mild, dull ache. The former is often the result of a sudden injury or sharp movement, whereas the latter can build over time, resulting from lifestyle choices like wearing unsupportive shoes or working out too hard. Here are some common causes of calf pain: Muscle Cramps. Sudden, involuntary contractions of the calf muscles, known as cramps, can cause significant tightness and discomfort. These cramps may result from factors such as dehydration, general muscle fatigue, or electrolyte imbalances. Overuse. Engaging in repetitive activities that involve a lot of running or jumping can overwork the calf muscles and make them feel tight. This is especially common when increasing training intensity or duration without allowing yourself to rest. Muscle Strain. Overstretching or tearing the calf muscles, often due to sudden movements or excessive force, can result in tightness, pain, and swelling. Non-supportive and Ill-fitting Footwear. Shoes lacking arch support, shock absorption, or cushioning force the muscles to work harder with every step. Without proper arch support, the foot may put excessive strain on the calf muscles as they attempt to stabilize the lower leg. A lack of shock absorption further increases the impact of the ground on the feet and legs. Similarly, insufficient cushioning fails to distribute pressure evenly, leading to increased stress on the calves, especially during prolonged standing or walking. Poor Ankle Mobility. Limited flexibility in the ankle joint can place additional strain on the calf muscles, contributing to tightness. Some causes include having a history of ankle injuries or arthritis. Pre-existing Gait Abnormalities and Foot Type. Overpronation (excessive inward foot rolling — common in flat feet) or underpronation (excessive outward foot rolling — common with high arches), can lead to calf muscle tightness due to altered mechanics and increased strain. Dehydration and Mineral Deficiencies. Lack of adequate fluids or essential minerals like potassium, magnesium, and calcium can lead to muscle cramps and tightness in the calves. Inactivity. Prolonged periods of inactivity or sedentary behavior can cause the calf muscles to become tight due to lack of regular movement and stretching. Venous Insufficiency. Conditions like deep vein thrombosis (DVT) or varicose veins can cause calf tightness, as well as general venous insufficiency. How Tight Calves Affect the Body and Feet We can feel the effects of tight calf muscles in more ways than one. Our feet can become weaker, more vulnerable and fatigued, sometimes leading to a foot condition we didn’t have before. Tight calves can also cause experience mysterious back and knee pain. Here are common additional problems can arise from strain in the lower legs. Joint Pain Tight calves can have a significant impact on the body's overall alignment, posture and movement, often leading to joint pain in the knees, back, and feet. When the calf muscles are tight, they restrict proper ankle dorsiflexion (raising the foot upwards towards the shin). When ankle mobility is restricted, the body may lean forward slightly to maintain balance, causing strain on the lower back muscles and leading to chronic discomfort. This abnormality can put excessive strain on other joints, like in the knees. This perfect storm of joint problems and limited movement can contribute to conditions like osteoarthritis over time. Biomechanical Foot Conditions The feet often bear the brunt of tight calf muscles, as they have to absorb additional stress during movement. Calf pain can cause a disrupt our running or walking gait as we try to move through the pain. Further, since our calf muscles connect our knees to our ankles, when the calves become tight it puts strain on the ankle. This disrupts our foot mechanics and can cause painful, chronic overuse injuries like plantar fasciitis and Achilles tendonitis. In fact, tight calves is one of the leading contributing factors to Achilles tendonitis and plantar fasciitis. Increased Risk of Injury Aching, tense muscles are more susceptible to further strains and tears, in addition to also causing balance problems as you struggle with pain. All of this combined can be a recipe for disaster and lead to a slip or fall (especially in seniors) that may cause even more damage, like a broken bone. Tight calf muscles can also contribute to more mild conditions like shin splints (repetitive stress on the shin bone) and generally hinder athletic performance. Circulatory Problems The calf muscles assist in pumping blood back to the heart from the lower extremities. Tightness in these muscles can impede this process, resulting in swelling in the feet and ankles and, in severe cases, contributing to circulatory problems. How to Treat Tight Calves: Muscle Tightness and Foot Care https://www.youtube.com/shorts/sNdIAxZNOn8 A foot care professional can help with calf tightness and pain. With their guidance and your determination to improve your foot and leg health, you can live and move comfortably. Let’s explore some options. Compression Stockings Wearing medical-grade compression stockings can improve circulation in the lower legs, reducing muscle fatigue and tightness and giving your lower extremities a healthy, comforting and energizing boost. They work by applying gentle pressure to the legs, which helps prevent blood pooling and promotes better oxygen delivery to the muscles. Compression therapy is especially useful for individuals who spend long hours on their feet, live a sedentary lifestyle, spend prolonged periods sitting while travelling, pregnant women, or those with conditions like varicose veins. A physician can determine the right level of compression based on your specific needs. Custom Orthotics Custom orthotics can help address underlying biomechanical issues that contribute to tight calves. A chiropodist can assess foot structure to design orthotics that conform to your feet, and yours alone, providing tailored support and alignment for your unique needs. By correcting imbalances and reducing strain on the lower leg muscles, orthotics can help alleviate tightness and prevent further discomfort. These devices can be particularly beneficial for individuals with flat feet, high arches, or abnormal gait patterns that place excessive stress on the calves. Proper Footwear Shoes with adequate arch support, cushioning, and shock absorption that redistributes pressure away from the heel can help keep your feet comfortable, maintain proper lower limb alignment and reduce strain on the calf muscles. Chiropodists and podiatrists often advise against wearing unsupportive footwear like flip-flops or high heels for prolonged periods, as they can contribute to muscle tightness and discomfort in the calves and feet. Strengthening Exercises and Stretching Programs A structured exercise program focusing on calf flexibility and strength can significantly reduce tightness. Chiropodists can recommend targeted stretches that target the gastrocnemius and soleus muscles — helping improve range of motion in the lower leg and fighting off stiffness. Calf raises in particular (see demonstration below) can enhance muscle endurance and prevent recurring tightness. Incorporating these exercises into a daily routine can improve mobility and reduce the likelihood of calf-related discomfort. Some other good examples of stretches for calf muscles include the Soleus Stretch and Heel Stands. Click the links for Feet First Clinic demonstrations! https://www.youtube.com/shorts/ZVSfzY6so8w

March 13, 2025

Do Flat Feet Cause Bunions?

Flat feet are a condition in and of themselves. However, flat feet also have an impact on future foot health and can lead to other more painful foot conditions. But can flat feet really cause bunions? While it seems unlikely that a toe deformity can be linked to a flat arch, you'd be surprised how interconnected our lower extremities are, especially the feet! Today’s article will explore how flat feet cause bunions, what you can do to prevent them, and how a foot specialist like a Chiropodist or Podiatrist can provide treatment. What are Flat Feet? Flat feet, or pes planus, cause the entire sole or most of it to contact the ground when standing and walking. For some people, this condition can extend into adulthood from childhood (children have flat feet before the arch forms) when the arch fails to form.When you have normal arches, they provide an elastic, springy connection between the forefoot and the hindfoot, allowing forces incurred during weight-bearing to be distributed properly. When these arches don’t exist, this mechanism is disrupted, leading to pain and other complications. What are Bunions? https://www.youtube.com/shorts/sXF8lWHad0g Bunions, or hallux valgus, are bony protrusions that form on the inside edge of the first metatarsophalangeal (MTP) joint at the base of the big toe. They develop when pressure causes the big toe to deviate toward the second toe, resulting in a misalignment of the joint. Emerging research indicates that hypermobility in the midfoot (specifically the mid-tarsal joint between the navicular and the base of the first metatarsal) may be a key underlying factor in the development of bunions, and this hypermobility is often genetic. Common Bunion Causes and Risk Factors: Ill-Fitting Footwear: Wearing the wrong shoes for years is a major risk factor for most foot conditions, especially bunions. Wearing tight, narrow, or high-heeled shoes can exacerbate pressure on the big toe joint, contributing to bunion formation. Your toes need space to splay and rest comfortably! Gender and Age: Women, particularly those over 60, are more prone to developing bunions, generally due to decades spent making poor footwear choices, or possibly due to hormonal influences that affect the ligaments in the foot. Inflammatory Conditions: Diseases like rheumatoid arthritis can cause joint inflammation, which increases stress on the big toe and the risk of bunions. Foot Injuries: Trauma to the foot can alter its mechanics, leading to bunion development. https://www.youtube.com/shorts/KZiVzLyBUMo Flat Feet and Bunions: The Connection If you’re not proactive, the shape of your foot arch can have a big impact on our foot health over time. You may know that flat feet can lead to plantar fasciitis, and you may also know that high arches can lead to back pain, but our arch shape can affect us in countless ways. Let’s talk about the science behind why a flat foot can lead to a painful bunion. It all boils down to flat feet causing an abnormal gait (walking pattern), and the damage caused by walking with that abnormal pattern for a long period of time.The structural anomaly of flat feet and barely having an arch, or no arch at all, can significantly impact foot mechanics—particularly during walking. In a typical gait cycle, the foot pronates (rolls inward) to absorb shock and then supinates (rolls outward) to create a rigid lever for propulsion. Individuals with flat feet often experience overpronation, where the foot remains excessively rolled inward during the push-off phase. The altered biomechanics increases pressure on the first MTP joint, leading to instability and misalignment. Over time, this persistent stress can cause the big toe to deviate toward the second toe, resulting in a bunion. Moreover, flat feet can lead to muscle imbalances that exacerbate bunion formation. Weakness in the intrinsic foot muscles (a group of tiny muscles inside the foot) and the tibialis posterior muscle (a muscle in your lower leg) compromises arch support, worsening overpronation. This chain reaction places additional strain on the big toe joint, accelerating bunion development. Therefore, the combination of altered foot mechanics and muscle imbalances associated with flat feet plays a significant role in the development and progression of bunions. https://www.youtube.com/shorts/pdyv58z1D2Y Preventing Bunions With Flat Feet First and foremost, it’s all about the shoes! Selecting footwear that fits properly with a wide toe box and adequate arch support is crucial. A spacious toe box prevents crowding of the toes, reducing pressure on the big toe joint and minimizing the risk of bunion formation. Adequate arch support helps maintain proper foot alignment, distributing weight evenly and alleviating stress on MTP joint. Avoiding high heels and narrow shoes is essential, as they can exacerbate foot misalignment and increase the likelihood of developing bunions. Incorporating custom orthotics can provide even more arch support if you have flat feet. These orthotics help correct overpronation—which we know now is a common issue—by stabilizing the foot's movement during the gait cycle and keeping it in neutral alignment. By improving foot alignment, orthotics reduce undue pressure on the big toe joint, reducing your risk of bunion development. Lastly, Engaging in specific exercises can strengthen the muscles supporting the foot arch, enhancing stability and function. These exercises should aim to: Strengthen Foot Muscles: Targeting the intrinsic and extrinsic muscles of the foot to provide better support for the arch and improve overall foot stability. Improve Flexibility: Enhancing the range of motion in the toes, feet, and ankles to prevent stiffness and reduce strain on the MTP joint. Enhance Balance and Coordination: Developing proprioception to ensure proper foot placement and gait mechanics, thereby reducing the risk of misalignment. Regular practice of these exercises can improve foot biomechanics, reduce overpronation, and subsequently lower the risk of bunions. See below for an example of a great flat foot exercise. https://www.youtube.com/shorts/whJ3TZAOn00 Foot Clinic Bunion Care If you already struggle with bunions and foot pain, don’t worry; there are plenty of options available to you. Bunions cannot be reversed after they form, but they can be managed with guided care from a podiatrist or chiropodist. The goal is to avoid invasive surgical intervention while still preventing bunions from impacting your daily life as much as possible. Most of these bunion treatment options are available at our downtown Toronto foot clinic: Footwear Modification. Wearing shoes with a wide toe box and avoiding high heels can help reduce pressure on the bunion. Orthopedic shoes designed to accommodate bunions provide additional support and comfort. Anti-inflammatory Medication. Over-the-counter NSAIDs, such as ibuprofen, can help reduce inflammation and alleviate pain associated with bunions. Bunion Splints and Aligners. Devices like bunion splints and toe spacers can help realign the big toe and reduce discomfort. They can provide symptomatic relief, and you can try a more rigid device if your bunion is severe. Therapeutic Taping. Applying tape to the foot can help maintain proper alignment and reduce strain on the bunion, providing temporary relief from pain and inflammation. Shoe Stretching. Professional shoe stretching can create additional space in the shoe, reducing pressure on the bunion without altering the overall size of the footwear. Supportive Insoles or Custom Orthotics. Custom orthotics can provide support to the arches and correct faulty biomechanics. This can potentially slow the progression of bunions by reducing pressure on the first MTP joint. Bunion Exercises. Strengthening foot muscles through specific exercises can improve joint stability and decrease bunion-related pain. Try these 5 simple exercises for bunions. Shockwave Therapy: This non-invasive treatment can address tight muscles and soft tissue injuries associated with bunions. This can potentially reduce pain and improve function. Implementing these non-surgical interventions can significantly alleviate discomfort and slow the progression of bunions, enhancing overall foot health and quality of life. https://www.youtube.com/shorts/8g43ZWreZ1g

March 6, 2025

Palmoplantar Keratoderma: What is it?

Figuratively speaking, it’s a good thing to have “thick skin,” right? But if you have palmoplantar keratoderma, it’s a different story. This condition, sometimes shortened to PPK, refers to a group of foot skin disorders characterized by thick, rough, and yellowed skin on the hand palms and feet soles. These conditions can be either inherited or acquired. In today’s article, we’ll explore the symptoms, causes, and, most importantly, the treatment options available. This type of skin thickening may warrant a trip to a foot clinic and the expertise of a foot care professional, such as a Chiropodist or Podiatrist. However, successful treatment may depend on the underlying cause of the skin thickening. What is Palmoplantar Keratoderma? This condition combines two scientific terms: palmoplantar, which specifically refers to the skin on the soles of the feet and the palms of the hands, and keratoderma, a term for epidermis (skin) thickening. In less common cases, transgradient keratoderma can affect the top of the hands and feet. The feet are usually more severely affected than the hands. Palmoplantar keratoderma (PPK) causes thickened skin on the palms and soles due to an overproduction of keratin, the protein that forms the outer layer of the skin. Normally, keratin helps protect the skin from friction, pressure, and environmental damage. However, in PPK, something disrupts the balance of keratin production and shedding, leading to excessive buildup. This happens because of genetic mutations or external factors that affect how skin cells grow and mature. Inherited forms of PPK often involve mutations in genes that control keratin formation or the connections between skin cells. These mutations make the skin cells more resistant to breaking down, so they pile up instead of naturally shedding. Since the palms and soles experience the most pressure and friction in daily life, they are especially prone to this excessive keratin buildup. Over time, the thickened skin can cause pain or become hard and cracked, depending on the severity of the condition. Some types can also cause blisters to form. Types of Palmoplantar Keratoderma and Associated Symptoms https://www.youtube.com/shorts/-iNFLGednYY Genetic (hereditary) keratoderma is usually divided into three main categories: diffuse, affecting the entire hand palm and foot sole; focal, where thickening is limited to pressure points; and punctate, which appears as small, hard lesions. Some genetic PPKs - particularly diffuse - are syndromic, meaning they are associated with other health conditions and additional symptoms, ranging from hearing loss to nail abnormalities to internal organ damage. Acquired PPK, on the other hand, is always syndromic and develops later in life due to external factors such as infections, inflammatory diseases, or underlying systemic conditions like internal malignancies. Acquired forms may be easier to treat since you and your healthcare team can address the underlying cause. Acquired PPK is also more common than genetic, since there are more causes and risk factors associated with it. Most types of PPK cause varying degrees of thick skin, potential foot odor (as a result of sweat combined with thick skin) and yellow/discoloured skin. Genetic PPK Types and Symptoms Diffuse PPK This form presents with even thickened skin on the palms and soles, often with a red border at the edges. Symptoms typically appear in early childhood and may include excessive sweating (hyperhidrosis). The thickening is usually confined to the palms and soles, without extending to the tops of the hands or feet. Focal PPK This type is characterized by linear (striate) thickened areas on the palms and soles, often following the lines of skin tension. It is typically caused by mutations in genes encoding desmosomal proteins, which are crucial for cell adhesion. A specific type of focal PPK called Pachyonychia Congenita is a rare genetic disorder that can also cause thick toenails. Punctate PPK This form is characterized by multiple small, hard, corn-like lesions scattered on the palms and soles. It is associated with mutations in genes that play a role in skin cell function. Acquired PPK Types and Symptoms PPK from Infections (syphilis, etc) Rough, scaly and yellow thickening on the palms and soles. May come with a rash or other symptoms affecting the whole body. Clears up when the infection is treated. PPK from Inflammatory Skin Conditions (psoriasis, eczema) Thickened, inflamed skin with redness and scaling. Can extend beyond just the palms and soles. Often improves with medicated creams or treatments that calm the immune system. PPK Linked to Other Health Conditions (cancer, hormone disorders) Yellow thickening of the palms and soles that appears suddenly in adulthood. Can sometimes signal an underlying health issue, like cancer. Needs further medical evaluation to check for possible internal diseases. What is the Difference Between Palmoplantar Keratoderma and Calluses? PPK is not the only cause of skin thickening on the feet and hands. In fact, it is more rare than another common culprit: calluses. But how do you know which condition you have? Calluses are localized areas of thickened skin that develop as a protective response to repeated friction or pressure. Commonly found on individuals who are physically active or spend long hours wearing ill-fitting shoes, they are much less severe than PPK. PPK tends to be thicker and more noticeable, alarming and unsightly than calluses, often covering a larger, symmetrical area on the palms and soles. It can appear hard and more yellow, or red and flaky. In some PPK cases, you may observe a red band at the edges of the thickened skin. Calluses can have a more mild appearance (but not always; they can sometimes be thick and painful!), with some people not even realizing they have them. Does that mean that PPK is the same as having excessive calluses? Not exactly. Calluses are only caused by friction and pressure----whereas PPK always has a driving force behind it, whether it's a genetic mutation or the result of an illness. https://www.youtube.com/shorts/yBACD8bUim0 Palmoplantar Keratoderma Treatment: Can a Chiropodist or Podiatrist Help? While there is no outright cure for certain forms of PPK, Chiropodists and Podiatrists can help manage symptoms, reduce discomfort, and improve mobility. This typically involves regular debridement (carefully removing excess skin), possibly prescribing medicinal products, and offering footwear advice to minimize friction and pressure. The latter may also include prescribing custom orthotics to properly distribute pressure on the bottom of the feet, especially if the thickened skin is impacting daily life. Scheduling an initial assessment is a good start! Naturally, since PPK can be linked to an underlying condition, more comprehensive care may be needed. A Chiropodist or Podiatrist might become a part of a broader team of healthcare professionals that can help you, including a dermatologist, your family doctor or other specialists trained to tackle the root cause. You may need advanced treatments such as topical retinoids, corticosteroids, or even laser therapy in some cases. https://www.youtube.com/shorts/sBIdll7qylQ

February 27, 2025

The Connection Between High Arches and Back Pain

Dealing with high arches and back pain can be a challenging combination, as the two are more connected than they seem. Understanding how high arches contribute to back pain is key to finding effective treatments and preventing further issues. Whether you’re dealing with foot pain, back pain, or posture problems, addressing high arches can significantly improve overall comfort and protect the rest of your body—especially your back. What are High Arches? https://www.youtube.com/shorts/osC-UmBtgNk High arches (or cavus foot or pes cavus) is a condition where the foot has an abnormally pronounced arch (as opposed to a flat foot or a normal arch). Having high arches can be due to simple genetics, inheriting structural abnormalities in the foot from your parents. They can also be caused by several neuromuscular disorders, which are conditions (ranging from mild to severe) that cause dysfunction or muscle weakness and leave certain muscles inactive. High arches generally develop during or after childhood when the flat feet most children have start to take shape and the foot arch forms. In some cases, idiopathic pes cavus occurs without a known cause (like genetics or neuromuscular disorders), and is just a case of simple variations in bone and ligament structure. A pronounced foot arch is usually quite discrete, aesthetically, and isn’t a serious condition. However, high arches are a common cause of foot pain and discomfort. High arches put extra pressure on the heel and ball of the foot, affecting normal pressure distribution and making it harder to absorb shock properly. This can lead to heel pain (plantar fasciitis— which is also commonly linked to flat feet feet), arch pain, and more, as the muscles and ligaments supporting the foot work overtime to stabilize each step, leading to inflammation or strain. High arches often cause the foot to roll outward, a motion known as supination. This can place extra stress on the ankles and knees, further disrupting alignment and increasing the risk of injuries like sprains and shin splints. It’s important to schedule an assessment with a foot specialist, like a podiatrist or chiropodist, if having high arches affects your daily life. The Connection Between High Arches and Back Pain https://www.youtube.com/shorts/7m3SQ5dXaeg A pronounced arch can also lead to back pain. But how do high arches affect the back when the two areas seem relatively far apart? The answer lies in how the body stays balanced. Many foot problems, not just high arches, often cause back pain—along with knee, leg, and ankle discomfort—because the feet serve as the body's foundation (carrying your weight) and closest connection to the ground. When that foundation is misaligned and overworked, the entire body has to compensate, leading to strain in other areas. Simply put, everything is connected, and the feet play a crucial role in maintaining functionality throughout our body’s kinetic connection! When it comes to the back, pain and poor posture often coexist. As we know, when the arches are too high, they can throw off the body's natural alignment, affecting the way you stand and walk. Uneven weight distribution forces the lower body to compensate, which can lead to foot pain and posture issues over time. The strain on the feet may cause the ankles to supinate, shifting stress to the knees and hips. This misalignment can travel up the spine, making it harder to maintain proper posture and increasing the risk of chronic discomfort. Without proper shock absorption, the impact of each step travels up through the joints, leading to tension in the lower back and shoulders. Over time, these small imbalances can create lasting posture problems, making everyday movements more difficult. Treating High Arches and High Arch-Related Back Pain When you treat high arches, you’re also preventing any potential back pain that may occur further down the road. But if you already struggle with high-arch related back pain, you can still focus on treatment methods that simultaneously target both issues. Video Gait Analysis https://www.youtube.com/shorts/Rhuga6vLdc0 This is when a Chiropodist or Podiatrist assesses your walking patterns (also known as your gait) using video gait analysis equipment. It can give foot care professionals insight into the potential damage your high arches could cause, so they can recommend preventative treatments. Custom Orthotics and Insoles A Podiatrist or Chiropodist can prescribe custom orthotics that you can wear inside your shoes. They will provide much-needed arch support, distribute weight evenly, and reduce strain on the feet and spine. Another option is over-the-counter Superfeet insoles, with the Superfeet Green: All Purpose High Arch being a good choice to ask your foot specialist about. Supportive Footwear Look for shoes with good arch support, cushioning, and shock absorption to minimize impact on joints. People with high arches should wear shoes with flexible midsoles or rocker soles to improve movement and reduce strain. Cushioning running shoes with shock absorption help counteract supination, ensuring even pressure distribution and healthy biomechanics. Avoid high heels, rigid soles, and unsupportive flats, as they can increase discomfort. Read more about the link between footwear and back pain. Stretching and Strengthening Exercises https://www.youtube.com/shorts/-EeyHTdkrEs Targeting the feet, calves, and lower back can improve flexibility and stability, reducing pain. Some of the best include towel stretches (where you place a towel under your foot arch and pull towards you), seated toe pulls (pulling the top of your foot towards you - see above!), ankle circles and massage ball rolls (rolling your foot arch on a therapeutic massage ball). You can read more about them, including how to perform them, here. You can also try clamshells on an exercise mat with your ankles together (this will also help soothe hip pain. See below for a demonstration! https://www.youtube.com/shorts/ZODK0Q4zOws

February 13, 2025

How do Toe Spacers Help Your Feet?

From athletes to homebodies, toe spacers are all-the-rage these days and provide many benefits. Toe spacer benefits include correcting toe misalignment, better balance and posture, foot pain management and even improved circulation, making them a great foot care tool. They can also help with conditions like bunions and hammertoes. But exactly how toe spacers help your feet comes down to their ability to gently separate the toes into their natural position. Let’s take a look at everything there is to know about how you can use toe spacers to improve your foot health, the different types of toe spacers, and more! What Are Toe Spacers? Toe spacers are small devices placed between the toes to create separation and encourage proper toe alignment. They come in various designs, colours and may be made with different materials, but their primary function is to counteract the tendency of toes to crowd together. This separation helps maintain the foot's natural shape by preventing the toes from overlapping or pressing against each other. While commonly associated with bunion and hammertoe relief or foot pain management, toe spacing devices also play a role in reshaping the way the toes interact with the ground. This improves overall foot mechanics—which in turn can help prevent even more foot conditions. But you don't need to have a foot condition to benefit from toe spacers: many professional athletes use them too! The way toe spacers work is rooted in biomechanics and how the foot is structured to distribute weight and movement. The toes are meant to splay naturally when standing, walking, or running, which helps with balance and stability. However, when toes are compressed for long periods, the ligaments, tendons, and soft tissues adapt to this restricted position. Toe spacing devices apply gentle but consistent pressure to push the toes apart, stretching these tissues, opening the joint spaces and encouraging them to return to a more natural alignment. This process doesn’t happen instantly but occurs gradually as the foot readjusts, influencing how force is distributed with each step. If you’re wondering if toe spacers will work for you, you can consult with a foot specialist like a Podiatrist or a Chiropodist. They are also available to purchase at our Toronto foot clinic, in addition to many other useful foot care tools! https://youtube.com/shorts/fFNkHZ-xqZM?feature=shared Types of Toe Spacers Many varieties of toe spacers are made with silicone gel as it’s a durable material and easy to clean. Some toe spacing devices are slim enough to fit comfortably inside shoes, making them ideal for all-day wear, while others are thicker and designed for use while resting. They also come in both four-toe and five-toe variations—the only difference being whether the pinky toe is separated. According to Runner’s World, four-toe spacers are great for mobility exercises and yoga, while five-toe spacers provide better support during workouts and daily activities. Since foot conditions like bunions primarily affect the big toe, some spacers are designed specifically for that toe. While technically more of an “aligner” than a “spacer,” the Infracare Ultra Thin Bunion Aligner is a good toe spacer for bunions made from a gentle material called power net and easily slips over the big toe. https://youtube.com/shorts/8g43ZWreZ1g?feature=shared Benefits of Toe Alignment and Toe Spacers Toe spacers help a wide range of individuals—from athletes to those with severe toe deformities and mobility issues. They offer the following benefits: 1. Improved Toe Alignment Toe spacers help open the joint spaces and restore more of the natural spacing between toes, which is often lost due to years of wearing narrow and restrictive footwear. By gradually repositioning the toes, they encourage a more anatomically correct foot shape and improve overall foot function. 2. Better Foot Stability and Balance Proper toe alignment allows for a wider and more stable base of support, improving balance and weight distribution. This is particularly beneficial for activities that require strong foot control, such as running, yoga, and weightlifting. 3. Reduced Muscle and Joint Strain Misaligned toes affect how the foot moves. This means muscles have to compensate and move in ways they weren't designed to, leading to strain on surrounding muscles, tendons, and joints. Toe spacing devices help the foot function more naturally, reducing stress on the plantar fascia, ankles, knees, and even the lower back. Remember, everything is connected! 4. Increased Toe Mobility and Strength Separating the toes promotes greater movement and activation of the small intrinsic foot muscles inside the foot (there are also many exercises that work these muscles!). Over time, this can improve toe dexterity, making movements like toe spreading and gripping more effective. This is helpful for both everyday activities and athletic performance. 5. Enhanced Circulation Tightly compressed toes can restrict blood flow to the feet. Toe spacers encourage better circulation by relieving pressure between the toes, potentially reducing numbness, tingling, and cold feet. 6. Reduce Friction Toe spacers may help reduce the uncomfortable friction in your shoes that leads to skin conditions like calluses, corns and blisters. Benefits of Toe Spacers for Athletes Athletes, especially runners, lifters, and those who practice barefoot activities like yoga, or even martial arts, rely on strong, well-aligned feet for optimal performance. Toe spacers encourage natural toe splay, which improves ground contact and enhances stability during movement. For runners, this means better natural shock absorption and energy transfer with each step, reducing the ground’s harsh impact on the knees, ankles and rest of the foot. Weightlifters benefit from a stronger, more stable base when performing compound lifts like squats and deadlifts, as the toes are better positioned to distribute force evenly through the foot. NFL star George Kittle was even shown using them in the Netflix series Receiver. Additionally, because toe spacers promote intrinsic foot muscle activation, they help athletes build strength in the smaller stabilizing muscles of the feet, which can reduce the risk of overuse injuries like plantar fasciitis and metatarsalgia, as well as stress fractures (tiny cracks in the bones of the foot). They can also prevent cramping and foot fatigue, particularly during long training sessions. By keeping the toes properly aligned, spacers relieve tension and improve circulation, helping to prevent that burning or aching sensation after prolonged activity. They also encourage proper foot posture and a normal gait, which can positively affect overall biomechanics. Benefits of Toe Spacers for Bunions and Hammertoes Bunions and hammertoes are common foot deformities that develop from prolonged toe misalignment, often made worse by wearing tight or ill-fitting footwear for years. For toe deformities, toe spacing devices help to push the big toe away from the second toe in the case of bunions and allow curled toes to stretch into a more natural position for those with hammertoes. This not only slows the progression of these conditions but can also help alleviate pain caused by pressure and friction between the toes. For individuals with bunions, toe spacers help counteract the drift of the big toe by encouraging it to stay aligned with its natural position. Over time, this can reduce strain on the first metatarsophalangeal (MTP) joint, which is where bunions form. By keeping the toe straight, spacers can also relieve pressure on the bunion itself, making it easier to wear shoes without pain. While toe spacers won’t reverse a bunion, they can help manage symptoms and prevent further misalignment. Hammertoes, on the other hand, often develop due to an imbalance in muscle and tendon function, causing one or more toes to remain in a bent position. Toe spacers gently stretch and realigning these toes, reducing stiffness and preventing them from becoming more rigid over time. This can improve comfort when walking and reduce the likelihood of corns or calluses forming due to excessive friction. Toe spacers offer a simple yet effective way to improve foot health, whether you're looking for better performance in sports or relief from common foot conditions. As always, it’s best to consult with a Podiatrist or Chiropodist before trying them yourself, especially if you aren’t sure what material or type to use. https://www.youtube.com/shorts/MZQ835Mw0I0 How to Wear Toe Spacers With Your Shoes To wear toe spacers with shoes, start by selecting a low-profile design that fits comfortably inside footwear. First, put on your spacers while barefoot and ensure they sit snugly between your toes without discomfort. Next, choose shoes with a wide toe box to accommodate the extra space needed for proper toe splay—narrow or tight-fitting shoes may compress the spacers and reduce their effectiveness. Plus, you shouldn’t wear ill-fitting shoes anyway! When putting on your shoes, loosen the laces or straps to allow more room, and consider wearing thinner socks to prevent excess bulk. Walk around to check the fit, making sure your toes can move naturally without pressure points. Begin with short wear times, such as 30 minutes to an hour, and gradually increase as your feet adjust. Remember: only thinner toe spacers will fit into your shoes. Thicker toe spacers like Yoga Toes are designed to be worn barefoot. https://www.youtube.com/shorts/sXF8lWHad0g

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