Are flexible flat feet associated with proximal joint problems in children?

Area of Science:

• Pediatric Orthopedics
• Biomechanics
• Musculoskeletal Health

Background:

• The relationship between flexible flat feet (FF) and musculoskeletal symptoms in proximal joints is not well understood.
• Investigating foot posture's impact on children's joint health is crucial for early intervention.

Purpose of the Study:

• To examine the association between foot posture, specifically arch height, and symptoms in proximal joints (knee, hip, back) in children.
• To explore potential links between foot posture and altered gait kinematics and kinetics.

Main Methods:

• An observational study involving 95 children aged 8-15 years.
• Foot posture assessed using the arch height index (AHI).
• Three-dimensional gait analysis conducted to evaluate kinematics and kinetics; pain frequency documented.

Main Results:

• Reduced arch height (flat foot posture) was significantly associated with higher odds of knee pain (p<0.01) and hip/back pain (p=0.01).
• Flat foot posture correlated with altered gait, including reduced vertical ground reaction force peaks and changes in hip/knee moments.
• Specific kinematic changes like increased pelvic retraction and knee valgus were observed in children with reduced AHI.

Conclusions:

• Children with flatter foot postures report more knee, hip, and back pain.
• While an association exists, the precise biomechanical mechanisms linking flexible flat feet to proximal joint symptoms require further investigation.
• Targeted treatment for FF should be informed by a clearer understanding of its relationship with symptoms.