Foot Malposition

What Types of Foot Malposition Are Known?

Foot deformities are very common in our society and can have various manifestations. Differences are particularly apparent when comparing foot deformities in childhood and adulthood because they can either be congenital or acquired throughout a lifetime. Depending on the degree of deformity, they can cause discomfort, which needs to be treated.

The most common foot deformities are the pes valgus, splay foot, flat foot, and drop foot. In addition, some deformities are specific to a particular age group, such as the hallux valgus in adults or the heel foot in children/newborns.

Foot Malposition in Children

Even in childhood, foot deformities can occur and cause problems. However, the range of these deformities is very wide, and each case must be evaluated individually regarding the need and possibilities for therapy.

The prognosis in childhood is generally considered good since the body is still developing, and deformities can be corrected more efficiently or even on their own. Childhood foot deformities include:

The Infantile Flat Valgus Foot

This is characterized by the flattening of the longitudinal arch of the foot, i.e., the inner side of the foot, and the associated inward inclination of the heel. In addition, a distinction is made between the flexible and the rigid flat valgus foot. The flexible variant usually occurs on both feet and is only treated if it also causes discomfort. The rigid form is rarer and almost always requires treatment to prevent late complications.

The Infantile Pigeon Toe

The decisive feature here is the arch-shaped rounding of the foot's inner side ("sickle-like"). In most cases, this deformity is congenital and occurs on both sides. In premature infants, however, the pigeon toe does not develop.

The Infantile Heel Foot

The heel foot is characterized by a deformity in which the foot is maximally extended toward the dorsum of the foot so that it comes to rest near the tibia. This malposition is often found in newborns, as the position in the womb forwards it. In most cases, the foot heals spontaneously, and treatment is unnecessary.

Foot Malposition in Adults

Various foot deformities are also found in adults. The following foot deformities are among the most important and most common ones that cause discomfort in adults:

Hallux Valgus

Hallux valgus is a deformity of the big toe in which the metatarsophalangeal joint of the toe is incorrectly positioned outward, causing the formation of a bunion on the inner foot. It is the most common deformity of the toes and occurs primarily in women. Hallux valgus can be brought forward by many factors, such as weak ligaments and muscles in the foot, other foot malposition such as bent foot, and being overweight. In addition, Hallux valgus is often caused by wearing shoes that are too tight or stiff.

In the early stages, this condition is treated conservatively with physiotherapeutic exercises. However, if the severity of the condition increases, a surgical approach is chosen.

High Arch

A high arch is a condition in which the longitudinal arch of the foot is too far from the ground, thus exerting an unnaturally strong load on the ball of the foot and the heel. As a result of this malposition, the foot is restricted in its mobility and reveals instability, among others, in the ankle joint.

As a result of the incorrect and excessive stress on the individual sections of the foot, further deformities and changes in the feet develop, such as splayfoot and claw toes.

A high arch usually shows a constant course with little discomfort or a progressive course with increasing problems and pain. The treatment depends on the condition's cause and can range from orthopedic insoles and physiotherapy to surgical correction.

Drop Foot or Flat Foot

A fallen arch is a foot deformity in which the longitudinal arch of the foot is too close to the ground. In extreme cases, it can even rest on the ground, defined as a flat foot, whereby the clinical pictures merge seamlessly. The flat foot is widespread in our society. About every one out of five people is affected by it.

These foot deformities are often caused by a preceding flat valgus foot problem or instability in the muscles and ligaments of the foot, which can be developed by, among others, a lack of exercise. In addition, obesity is considered a risk factor.

Pain often occurs when the fallen arch develops into a flat foot and is usually localized inside the foot. If the flat foot is fully developed, the pain on the inside stops, but there is now increased pressure on the sole, and discomfort appears there.

Flat feet and fallen arches are treated with the help of orthopedic insoles, whereby the treatment of fallen arches achieves much better results than that of flat feet.

Splayfoot

Splayfoot is a foot deformity in which the forefoot is pushed further apart by pressure, i.e., it is widened. Due to this widening, the metatarsal bones are under too much stress and cause pain in the forefoot area. The cause of splayfoot is the genetic predisposition for development, overweight, and wearing the wrong shoes, especially shoes with high heels. The course of splayfoot and the associated complaints are usually progressive, and the deformity increases over time.

Special orthopedic insoles, which have a protrusion behind the metatarsal heads and help to relieve them, are used for treatment. The therapy generally achieves tremendous success the earlier it is initiated.

How to Recognize a Foot Malposition?

Foot deformities can become noticeable in different ways. They are often noticed because of pain and discomfort, especially after weight-bearing. Depending on the severity of the deformity, they can also be noticed with the naked eye, such as in the case of an extreme hollow foot or hallux valgus. Even everyday problems, such as frequent twisting or stepping, can indicate a deformity. If you suspect a foot deformity, you should see an orthopedic specialist who will examine your foot more closely and check for deformities.

When to See a Doctor and Which Specialist is Responsible

You should see a doctor if you suffer from pain and discomfort in the foot that is not caused by an acute injury and does not disappear even after resting the foot.

Patients with foot deformities should see an orthopedic specialist for appropriate treatment. The therapy can be supported by a physiotherapist, as specific stretching and muscle exercises can alleviate the symptoms and even prevent them in some cases.

Suppose a child shows deformities in the area of the feet. In that case, the first thing to do is to consult the pediatrician in charge, who will then refer the child to a specially trained pediatric orthopedist if necessary.

We will help you find an expert for your condition. All listed doctors and clinics have been reviewed by us for their outstanding specialization in foot deformity and are awaiting your inquiry or request for treatment.

Sources

• www.thieme.de/de/gesundheit/spiraldynamik-diagnose-51952.htm
• www.gesundheit.gv.at/krankheiten/koerper/fussfehlstellung/inhalt
• Vogt, Dominik M.: „Fußfehlstellungen im Kindesalter“ in Pädiatrische Praxis (2017), Band 88/2, Mediengruppe Oberfranken—Fachverlage GmbH & Co. KG