Shoe inserts may help relieve pain for mother, daughter

Q. I have two foot-related issues. I know that you are not a podiatrist but hope you can help anyway, since I reserve doctor visits for physicals and severe illness.

First, my daughter has flat feet and regularly suffers from leg pains that her doctor says are due to her flat feet and overactivity. She is only 5, and I worry that this is something she will have to suffer with for the rest of her life. Is there anything I can do to help her? I also worry that this will only worsen, as she is estimated to be nearly 6 feet tall when she is done growing.

Second, I have high-arched feet. I have recently developed a heel spur on one foot that over the course of about eight months caused worsening pain. It no longer aches the way it did, but it is still painful to stand on it after sleeping at night. The stiffness and feeling of swelling usually disappears within about 30 to 60 minutes. What do you recommend?

A. You are correct that I am not a podiatrist, who specializes in foot disorders. I can, however, offer you some general advice.

In the simplest terms, the feet are made of four regions, the toes, ball, arch and heel. The toes aid balance, the ball and heel are the primary walking surfaces, and the arch is like a spring that connects the two surfaces. As humans walk, the heel makes contact first, followed by the ball and toes.

The arch cushions the impact by flatting slightly to absorb the weight. It returns to normal when the weight has been removed.

Flat feet refers to feet that flatten too much during normal walking or standing. They tend to roll inward, which strains the tissue on the bottom of the foot. Essentially, the arch compresses too much. This can lead to heel pain, bunions and hammertoes. It can also cause shin splints in runners and ankle swelling and pain in more sedentary people.

Treatment for adults with flat feet generally involves shoe inserts that create an arch. I am unsure whether these are available in children's sizes. Speak with her pediatrician about possible orthotics or a referral to a podiatrist or orthopedic specialist.

In my experience, high arches are not as common as are flat feet. In your case, the arch isn't as flexible as it should be and doesn't absorb the shock of walking correctly. Essentially, your feet are the opposite of your daughter's.

High arches tend to cause the foot to roll outward, putting pressure on the outer ball, heel and big toe of your feet.

The condition can also cause heel pain, sprains and inflammation of the tendons of the ankle, stress fractures on the outer part of the foot and pain and calluses.

Treatment generally consists of gel inserts for shoes, which act as artificial shock absorbers; avoiding running and walking on hard surfaces (use grass or dirt surfaces instead); and wearing high-topped shoes with extra cushioning.

Both flat feet and high arches will benefit from regular stretching and strengthening exercises of the calf and foot. For severe or persistent pain, a podiatrist is the best option.

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