Q. Kindly explain about the tests required to check hypermobility and flat feet.

Answered by
Dr. Atul Prakash
and medically reviewed by Dr. Divya Banu M
This is a premium question & answer published on Nov 24, 2019

Hello doctor,

I have flat feet and need insole and boots to help me but also think I have hypermobility in ankles as I read they are linked. Is this true and what test can I do to find out?

Dr. Atul Prakash

Fitness Expert Orthopedics And Traumatology Physiotherapy Spine Health
#

Hello,

Welcome to icliniq.com.

Flat feet are not always symptomatic and neither do they need treatment as a rule. Issues such as pain, callosities, progression of dropped arch, etc., are reasons for seeking treatment. I am not getting enought information from your description to take this further. People with hypermobility are more likely to have flat feet and some may develop painful flat foot too. You may need correction through boots that will support the ankle as well as arch supports and a deep heel cup to control the heel valgus.

First of all, you need a full assesment as the exact cause of your flat feet, you will need physiotherapy to strengthen the intrinsic muscles, attentions to the tibialis posterior as well as the tendoachilles is needed. Shoe inserts or custom shoes may be needed. You will need X-rays to assess the deformity and this may act as a base line to assess further progression.

If you need further info then please send a detailed description and perhaps a clinical note from your podiatrist or physiotherapist A clinical picture of your feet while standing picture taken from the sides and back will help more.


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Thank you doctor,

I go to hospital 1 to 2 times a year for stability boots or insoles depending what I need at the time. I have always had flat feet and need insoles but I did not know I had them from 18 so I did get insoles till then but only in the last few years, I need boots as well as insoles as one do not work with the other but both together help and I cannot walk far without them. I cannot use boots from high street shops due to not enough support in them due to ankles bending too much.

What did you mean by you may need correction through boots that will support the ankle? Could this mean I may have hypermobility with flat feet and could this only happen in just ankles? If so, is there any any test or other ways I can find out? I have sent some picture of feet as you said I have also sent pictures of boots as well.

Dr. Atul Prakash

Fitness Expert Orthopedics And Traumatology Physiotherapy Spine Health
#

Hello,

Welcome back to icliniq.com.

The pictures that you have sent show that you have a flat foot, your medial arch has dropped and you seem to have a small bunion too (attachment removed to protect patient identity). I cannot see any callosities on the top of the foot (do you have any on the sole)? The piedro shoes are custom made and are fine (they look well made, are above the ankles and I did see a insert (greenish), does this have an arch support?

What I meant to say was that the heel cup with the counter are able to grip the heel and stops it from going into valgus which is the primary deformity and the heel height is maintained which allows the arch and forefoot to maintain the natural shape aided by an arch support. The ligaments and bony architecture are all static in nature and have to be helped by the muscles like the tib post and the, intrinsics, tib ant to counter the tendoachilles.We need to keep them in best shape you need physiotherapy to help improve the strength in these muscles and to keep the tendoachlles loose.

If you are hypermobile then the ligaments are already stretched and the static components are already not doing their job. What is you beighton score? If you have bony changes in the subtalar joint then you may need to start thinking about surgery sometimes in the future.

Before we get there have you undergone physiotherapy? How great can you walk with the piedros? Have you seen a foot and ankle specialist?


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