Flat Arches Make Knee Pain Likely

This assessment is for an active 10-year-old boy. The first two photos show the arches of his feet without any load (photo 1 and 2, left frame). As the images demonstrate, even without any load, the height of the boy’s arches are compromised. As a result, his feet look flat. The images also show the height of the arch when supporting full body weight (photo 1 & 2, right frame). There is little difference in his arch between the loaded and unloaded conditions. 

A flatter-than-normal arch inhibits the body’s ideal impact-absorption process. This leads to greater stress and force on the spine, hips, knees and ankles, which means an increased risk of injury in those areas. Another effect of the flat arch: Compromised arches are unable to store, and thus return, energy during the loading process, so the muscles of the lower body must work harder throughout the movement pattern. 

The photos also indicate a collapsing left ankle (photo 3). This forces the left knee to deviate inward and creates a disproportionate shift in weight to the right side (photo 4). The deviation places undue stress on the ligaments and structures of the inner knee, rendering these areas susceptible to pain and injury.

Over time, the resulting imbalance will cause the right leg to become stronger than
the left leg. During my assessment, I could see this process already taking place: When performing lunges and single leg half-squats, the boy’s right leg was noticeably dominant. 

Orthotics would raise the arch and help absorb impact and force, thereby taking stress off the spine, hips, knees and ankles. Corrective exercises would target the left hip and left quadriceps. I would also recommend this client practice squatting with equal weight distribution.