Collagen and Flexible Flat Feet
Collagen refers to fibrous, triple helical glycoproteins that represent the building blocks of several structures of the body such as the skin, tendons, cartilage and the bones.
These form a major constituent of the extracellular matrix and are important for maintaining the structural integrity of connective tissues and for providing rigidity, elasticity and strength to the body.
With a considerable number of structural and functional disorders associated with dysfunctional collagen, the role of collagen in health and disease was further investigated by Sandhu et al. in their review on the subject.
The authors categorised collagen disorders as genetic, autoimmune and miscellaneous; heritable collagen disorders include Ehlers-Dalnos syndrome, Osteogenesis imperfecta and Marfan syndrome.
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Degradation of collagen can be linked to – the secretion of enzymes by cells that lead to the sequential, extracellular degeneration of collagen and other matrix molecule or the selective ingestion of collagen fibrils by fibroblasts and their intracellular degradation.
The aetiology of an acquired flexible flatfoot deformity includes ligamentous laxity which is normally associated with a collagen vascular disorder or age-related changes to the collagen structure which lead to decreases in the tendon’s elastic compliance.
As mentioned by Giza et al., this causes weakening in tendons and a subsequent failure of the static stabilisers of the medial longitudinal arch which in conjunction with poor blood supply can prevent adequate healing response, resulting in chronic inflammation, tenosynovitis and tendinosis.
A patient with flexible pes planus will often complain of calcaneal pain at heel strike, muscle spasm of plantar fascia, frequent ankle sprains, or pain in the lower back, knee or hip.
In order to improve symptoms, it is necessary to design treatment strategies that include weight loss consulting (if required), stretching and strengthening programmes, modification of repetitive loading activities and the regular use of customised foot orthotics such as MASS4D®.
The MASS4D® custom foot orthotic provides the structural support needed to manage postural abnormalities while addressing issues such as the collapse of the medial longitudinal arch and the eversion of the heel.
The inclusion of such an orthotic intervention in an active rehabilitation programme will typically yield positive results, providing a more holistic treatment for the patient’s condition.
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Flexible Flatfoot: Diagnosis & Treatment
Medial Arch Height
Configuration of the Plantar Fascia
References:
- Sandhu, S. V., Gupta, S., Bansal, H., Singla, K. (2012) Collagen in Health and Disease. Journal of Orofacial Research: July-September 2012, Vol. 2, No. 3, pp. 153-159.
- Giza, E., Cush, G., Schon, L. C. (2007) The Flexible Flatfoot in the Adult. Foot and Ankle Clinics of North America: July 2007, Vol. 12, No. 2, pp. 251-271. DOI: 10.1016/j.fcl.2007.03.008
- DiGiovanni, C. W., Greisberg, J. (2007) Foot and Ankle: Core Knowledge in Orthopaedics. Elsevier Health Sciences.
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