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Flat feet long term prognosis for juveniles

Discussion in 'Biomechanics, Sports and Foot orthoses' started by bkelly11, Jan 10, 2007.

  1. bkelly11

    bkelly11 Active Member

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    case history

    young male, 14 years old, Bi- lateral F/F varus, severe flat feet, hypermobility, clumsy slapping gait.

    4 years ago he was seen by a podiatrist C/O uni-lateral knee pain. diagnosis osgoods schlaters

    full length bespoke insoles supplied to improve foot posture-significant improvement in symptoms.

    this young male is a close relative. he is a very talented footballer and has created a lot of interest from some top clubs.

    however, i can foresee his running ability letting him down in the future, albeit he took a stretch recently a his running has improved slightly, a pitty as he has all the other qualities and an exceptional talent at this time.

    im currently a fourth year student and have supplied him with 3/4 length slimflex insoles to try and controll the abnormal and excessive pronation. with a veiw to cast him to make more dynamic insoles suited to his feet when i go back to uni and manufacture an EVA neutral shell.

    some expertise advice would be invaluble. whats likely to be the prognosis ??? i know hes not going to be a 100m champ

    Cheers bkelly11
    Last edited: Jan 10, 2007
  2. In order to fit devices in football boots you may want to make devices out of something more rigid to get control required with less bulk.

    If you were to look at the feet of the runners in the next olympic 100m final they should likely to be all be flat footed. What does this tell us?
  3. Admin2

    Admin2 Administrator Staff Member

  4. bkelly11

    bkelly11 Active Member

    with the intervention of foot orthoses, what can i expect the prognosis to be ??????
  5. bkelly11

    bkelly11 Active Member

    What does this tell us ????????????????????????????????????????????????????????????????????????????????????????????????????????????????????
  6. If this 14 y/o's feet were really that bad off then his football talents would not be that great in the first place. I tend to leave these patients alone and not suggest treatment at this age unless 1) they are having pronation-related pathology or pain with activity, 2) they have an inefficient gait which can be significantly improved with orthoses or 3) their parents have similar type of feet which has created problems for them into adulthood.

    Some of the world's best sprinters (i.e. 100 meter champions) have flatfoot deformity so I don't think I would be too worried over just a flatfoot in this 14 y/o unless he has something else that is giving him problems. Luckily, having championship-level sprint speed is not a requirement for football or there would be a very few soccer clubs in existence around the world. I would much rather have a football player on my team that can put a ball in the back of the net once or twice a gaime than have him/her be able to win the race from one side of the field to the other.
  7. bkelly11

    bkelly11 Active Member

    Thanks for your reply Mr kirby

    I can assure you that this boy has severe flat feet and is an exceptional footballer. he trains with the one of the top clubs in the country, he plays for the district team, and is involved at the moment in trials to play for his country.

    He presents with

    Helbing sign
    abducted feet
    Low MLA
    pattela internally rotated
    long thin feet (problems with good fitting football boots)
    he has anterior Knee pain after activity

    My point in the post was to find out if functional foot orthoses could improve his running ability and the possibilty of them being propholactic measure for him from developing serious pathology in the future. Do yo know of any research that has been conducted on orthotic devices to improve running ability??

    On another matter, i disagree with your theory of just being a good footballer. In my opinion and i express it is only my opinion that in todays game (football) to play at the top level you have to be a top athelete as well. You commented on a race from one side of the field to another, who would you have as a coach a) an average player with great pace who can outrun defenders and put the ball in the net or an exceptional player with all the skill in the world who is an average athelete who cant outrun defenders to put the ball in the net??

    thanks for your interest

  8. Podiatry777

    Podiatry777 Active Member


    I have a 10 year old son lanky, long.... long feet. loves to run!! Large forefoot varus-foot slap->too much grinding of bones-> knees medially rotate. aged 6 started winging:) sore feet/ sore shins/achilles(in any order). I ingnored him and about 7 yrs old I believed him. When you work podiatry, you don't want more at home. Finally I got Alpha orthotics(cork-firm but shock absorbing) and he felt better and if he does not use these pain comes back. Now I use sport type insoles from Briggate-thick in cushioning to toes and has various arch heights. Cost effective for my son CHANGES shoe size EVERY 6 months from day one. Ian Thorpe Feet??

    Make sure the 14 yr old stretches those Quadricepts- sounds like he realy needs it. Be gentle and set up easy routine. When he improves increase stretching. I often refer to physio for stretches if they don't know that Podiatrist can help. Reluctance to comply often is due to lack of information or supporting evidence, but in kids they just forget!

    All the best
  9. bkelly11

    bkelly11 Active Member

    Thanks for your reply Podiatry777.

    could you pass on more info on the sport style insoles-do they have a web address.

    i tried the stretching and your totally correct, getting him to comply is a nightmare-however, i will try again.

    cheers bkelly11
  10. Kelly:

    My point is not that absolute running speed is not important in the game of soccer (i.e. football). My point is that absolute running speed, by itself, does not make an elite soccer player. And if you read my original posting, I did not use an example of a player that could not put the ball in the net, I used the example of a player that could put the ball in the net. Soccer is more than absolute running speed, but obviously having both great skills and great running speed are most desirable in soccer.
  11. A strange bunch you Americans. Football, (a game played mainly with the feet) you call soccer. What you call American football, (as opposed to British football?) is a game played primarily with the hands. :confused: :rolleyes:

    You know i love you all.

    So far as football boots are concerned i tend to find that the ever contentious forefoot Varus extention gives a significant degree of symptom releive for a very modest amount of space in many cases.


  12. bkelly11

    bkelly11 Active Member


    Mr Kirby, im only looking for advice. And on the other matter i expressed an opinion that is obviously different from yours.... Todays game is not just about skill, i only commented that you need to get to the ball 1st to put it into the net. you said you wanted somone on your team that can stick the ball in the net and that you dont need to be a championship runner. I disagree with that

    Regrads bkelly11
    Last edited: Jan 11, 2007
  13. bkelly11

    bkelly11 Active Member

    Thanks Robert

    i will look into the F/F extension

    Cheers bkelly11
  14. Talk about strange games, how about that popular game called cricket where a bunch of guys in white suits play a game for days on end with basically nothing to do but chase an occasional ball hit toward them. It seems that tea time is more important in this game than doing anything that actually burns calories?? :confused:

    In American football the feet are used for

    1) Running
    2) Kicking field goals
    3) Punting at fourth downs
    4) Tripping opponents illegally when the referee is not looking
    5) Purposely stepping on opposing players feet and other appendages when the referee is not looking

    I would agree that the sport you call football, what we Yankees call soccer, is more foot dependent. It seems that the only function of the hands in soccer (excluding the goalie, of course) are more for making flailing motions while on the ground while the player is doing their best job acting to favorably impress the referees that they should pull a yellow or red card from their shirt pocket to flash in the face of one of the opposing players. :p
  15. If you don't provide us a name other than bkelly11, I thought that Kelly would probably be as good of a name as any to call you and probably is either your first or last name. Am I wrong??

    Regrads??.............What does that mean?? :p
  16. bkelly11

    bkelly11 Active Member

    think it means kind greetings or something like that.

    anyway toys are back in the pram

    :rolleyes: cheers bkelly
  17. :D

    Of course the tea is important. Is there anything more quintisentially English? Only fishing can match it for a sport involving a minimum of exertion.

    Shows how much i know about American football. I thought the idea of all the body armour was so you could run full pelt at the opposition and try to decapitate them! I assume from number 4 that it's only legal to trip your opponent when the referee IS looking. ;)

    The hands are also used by footballers for counting. Put mittens on the average center forward and they cant tell you the time after 4 o clock!
    Did you know the FA (football association) is entering into a collaberation with the royal shakespear company and the special effects studio responsible for "Saving Private Ryan" to improve performances from players?

    I only wish i could get hold of those sponges the physios run on the pitch with. They seem to get players from rolling around on the ground in agony with what appears to be a double spiral fracture of the leg at the very least, to sprinting up the pitch like gazelle* within minutes!

    If i could only isolate the active component in those sponges i'd be rich! Rich i tell you!



    *you'd be surprised how often you see a gazelle on a football pitch.
  18. Podiatry777

    Podiatry777 Active Member

    Hi there,

    Tech Soft full length comes in 4,6,8 degrees arch heights. Patient needs plenty of room as innersoles areat least 3mmm thick forefoot and more at heels.manufacturer InterPod have their websit. Stocked by Briggate. You need to decide on shoe suitability and arch height. men love these soft very cushioning innersolles-cost $34. ;)

    I won't get involved in your football chat-easy for me the game does little for me, sorry. My lanky son is wondering why mum has been on computer 1st thing, I'm sure :eek:

    Bye for now
  19. Heather J Bassett

    Heather J Bassett Well-Known Member

    Hi, Some personal anecdotal experience with the twisting and turning associated with Aussie rules rigid OT's often can not be tolerated. I have had top level footballers who wore rigid OT's for day to day wear and running but softer devices for the game. Others who wore rigid for game.
    Having played and treated my team mates at an International level of sport...I could not function without my rigid OT's but some team mates could and some team mates could not wear rigied during the game.
    2 of my team mates had the similar feet to your description, one was fast the other much slower BUT all three of us won the WORLD Series in a game with very similar running action to Aussie rules! So there are no rules on what feet are going to make or break you being that top athlete. On a different note age 13 year old son with size 11 1/2 feet, Pes Planus doesn't getter any planor.....can't function without his rigid OT's and well laced boats oops I mean shoes
    kind regards Heather Bassett Pod Melbourne

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