One of the key determinants of functionality in the foot is the medial longitudinal arch.
When the natural arch of the foot is optimally supported in a closed chain stance position, balance is restored to the body.
Located along the medial side of the foot and formed by the metatarsal and tarsal bones respectively, the arch is additionally supported by ligaments such as the plantar aponeurosis, the talocalcaneal and the deltoid ligament which are all necessary to provide it stability.
A healthy arch is vital to sustain the weight of the body and to absorb the majority of the shock to the foot whilst performing any kind of physical activity. Any changes in its alignment or weakening in its elasticity can result in a number of pathological deformities.
The three common arch postures in this regard are the cavus (high-arched), neutral and pes planus (flatfoot).
An overly cavus foot would be susceptible to ankle sprains due to prominent heel tilt. Calluses and pain while walking or standing also occur due to the excessive weight placed on the first metatarsophalangeal (MTP) joint and lateral arch of the foot.
In the case of pes planus (flatfoot), there is a complete collapse of the medial longitudinal arch which causes the joints to function outside their normal range of motion. If left untreated, this can progress to cause postural abnormalities, affecting the patient’s ability to walk, run or perform any physical activities in the long run.
A neutral calcaneus, with an anterior facet level with the ground at heel strike, allows for an optimal medial arch and full range of motion of the ankle complex.
This is why it is necessary to support all articulations so they work well within their natural ranges of motion (ROM) while maintaining full functionality in the foot.
With scientific researchers having established a direct correlation between arch height and kinetics, foot supportive devices need to be calibrated considering all these aspects of the foot anatomy in order to achieve optimal amounts of functionality in the joints.
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