Saturday, May 09, 2020

Our Fallen Arches

It was the late Flanagan and Alan, members of the Crazy Gang, that gave us the unforgettable anthem for all foot weary, "Underneath the Arches."

(Video Courtesy: BaronVonPenguin Youtube Channel)

Anatomists tell us there are four real arches of the foot. The main long arch or instep, a smaller lateral arch which sits on the outside of the foot, an anterior arch which is made up of the ball of the foot and resembles a horseshoe of bones, and lastly a subtle arch across the mid foot. Like a garden hoe each metatarsal bone differs in length, the transverse arch cleverly allows all five of the metatarsal heads to touch the ground at the same time.

When the foot is resting on the ground there are only three small points of surface contact: underneath the heel, on the big joint at the ball of the foot and the corresponding small toe joint.

The rest of the foot is off the ground and a floating dome of converging arcs. A marvel of engineering. The foot arches have enabled humans to become the only creatures to be able to walk upright on two legs. All foot functions are not only arch related but also arch dependent. Not one arch can work alone but instead meld into one another to become inter-dependent.

The epicentre or power centre of the foot is where all four arches transect. Here with the elastic movement of the foot during walking, all energy forces of the absorbed weight converge from the arches into the epicentre. At a given time this stored energy is recoiled throughout the foot giving a distinct spring to the step. According to Rossi (1997) there is no single foot disorder that does not in some way involve one or more of the foot arches. Yet despite this the arches remain among the least understood, or most misunderstood, parts of the entire human body.

Fallen arches may be a common term but it is rather misleading and wrongly implies the arches collapse under strenuous duress. Not so and although symptoms may occur overnight these have little to do with actual collapse of the arches. Lone yachtsman, Tony Bullimore was found adrift in the cold waters off the south coast of Australia a few years back was found suffering from Trench Foot, a condition where the arches of the foot collapse due to exposure to excessive cold and damp. More recently ravers attending the Glastonbury Festival (UK) suffered similar symptoms due to the unexpected flooding. The vast majority of people complaining of metatarsalgia (pain in the sole of the foot) are misdiagnosed with fallen arches but their arches have not collapsed. Whilst metatarsalgia is less severe it is no less painful. There are many causes including impaired circulation, cramping, and nerve entrapment.

One condition common condition describes inflammation of the plantar fascia (or plantar fascitiis), sometimes also known as heel spur syndrome. The radiating pain associated often is mistaken for fallen arches. Shoes do not cause this discomfort primarily but may excite in feet prone to enthesopathy combined with prolonged activities such a walking and standing.

(Video Courtesy: University Foot and Ankle Institute, Santa Monica Youtube Channel)

Reviewed 09/05/2020

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