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Arch Support

The concept of the arches of the foot and the need for arch support has been debated for a very long time. There are so many misconceptions about "arches" and "arch support".

What are the arches of the foot?
There are generally considered to be two arches in the foot:
1 - The longitudinal arch is the obvious one and is the one most people mean when they say foot arch.
2 - The transverse arch is less obvious.

Dynamic function of the foot:
The foot is dynamic and during walking is always moving. The arch is going up and down - this is normal. So, while a "fallen arch" may not be a problem, it is how the arch functions during dynamic walking that is important.

The height of the arch - the "fallen arch”:
The height of the arch is not necessarily a problem - it is how the foot functions that can be the problem. There are a lot of people with high and low arches that never have problems.
There are a wide range of underlying causes for the arch lowering such as the foot pronating (there is not really such a thing as a "fallen arch" in the medical literature now).

What is arch support?
The arches are quite capable of supporting themselves if they are given help. The foot's own arch support mechanism is often called the windlass mechanism.
Devices such as foot orthotics are used to alter foot function, so the foot can restore its own arch. The idea of foot orthotics, which may look like good old-fashioned arch supports, is to facilitate this mechanism. Foot orthotics is not an expensive name for arch supports.

What are the symptoms of the foot that may need arch support?
Those with arches that are low do not always get problems. They will often get problems if they have a foot that is pronated (rolls inwards at the ankle).
The symptoms can vary from mild aches in the forefoot to arch pain to heel spurs - but do not forget that other things can cause the same symptoms.

Exercises to help the arch:
There are a number of exercises that have been suggested as helping "fallen arches", but the evidence is that they do not help (that does not mean they should not be done as many exercises can help some people).

Going to get a bit technical here to explain this.
* Some "experts" recommend exercises to strengthen the muscles in the arch to help "fallen arches".
* These muscles generally run from the heel bone to the bases of the toes, so theoretically they could raise the arch.
* Research studies that have used needles in these muscles to see how they function when walking show that they do not start contracting until just about the time that the heel comes off the ground.
* Making these muscles stronger with exercises is not going to do a lot of good, if the arches have "fallen" while the heel is still on the ground (which most are)
* Also the muscles are small and during propulsion (push off), a very large amount of force goes through the foot - can having them stronger really resist those forces?

If an "expert" advises exercise, ask him/her about this and what constitutes their evidence.


It is also worth noting that strengthening exercises will help in two situations:
* The use of exercises is probably good anyway to keep the foot healthy.
* If the cause of the problem is contributed to by weak muscles (which is uncommon), then the exercises will help - that's why the diagnosis of the cause is important.

Tight calf muscles are a common cause of a pronated foot that does cause the arch to lower (fall), so stretching these muscles plays a very important role.

Do not believe anyone when they say that arch supports or foot orthotics weaken the foot. There is no evidence either way and there are good arguments both ways. If an "expert" tells you this, ask them for the evidence.

What are the alternatives to arch support?

The use of foot orthotics is the mainstay of the treatment of what some consider to be "fallen arches".

Foot orthotics
(or "arch supports") will only help if the symptoms are due to abnormal function (or "fallen arches").

Not everyone with a problem needs a foot orthotic.

There are alternatives:
* exercises may play a role when indicated (see above)
* good supportive footwear, especially running shoes, can be used in most cases that are not severe