Monday, 29 December 2014

All You Need To Know About Flat Feet

"The human foot is a masterpiece of engineering & a work of art."
                                                                                                           -Leonardo Da Vinci

The human foot consist of 26 bones, 33 joints, 107 ligaments & 19 muscles which work together to balance your whole body. No wonder this great artist has named it as a masterpiece 1/4 of all bones in the human body are in the feet. Standing in the kitchen for cooking, walking down to buy vegetables playing any short of sport or dancing are all the activities we can do because of our feet. Healthy feet are key for active lifestyle. Human feet are designed to walk on natural surface like soil & sand, but instead of that we are walking on hard surface like pavements, marbles. That's why incidence of foot problems. Out of all flat feet is most common & unnoticed problem. If is it not diagnosis at right age, it can lead to serious complications in future. I get many patients saying, " My physiotherapist told me, I have flat feet & my family doctor says I don't have flat feet, I don't know what exactly flat feet means...!"

Flat Feet
What is Flat Feet ?
We have small gap on the inner side of feet when we stand, when this gap is not there it's called as flat feet. Everybody is born with flat feet, as a child starts walking his/ her arch starts developing. First five years of age are crucial for the arch development.

Effect OF Flat Feet On Posture:
All joints in our body work together. As feet are base of our body it affects entire posture. Following image will give you clear idea about how flat feet can affect alignment of all proximal joints.

Effect of Flat Feet

Knee Pain
  • Ligament laxity.
  • Muscle weakness/ Hypotonia of muscles.
  • Fracture/ trauma around ankle joint.
  • Family history.
  • Obesity.
  • Tired achy legs.
  • Heel pain, Knee pain & back pain.
  • Recurrent ankle sprain (Poor Balance)
  • Early osteoarthritis of joints.
  • Corn & Calluses etc.


Custom made orthotics is the main line of treatment for flat feet. People always try to get some off
the shelf orthotics & course it doesn't help for their problem. Orthotics correction should be based on lots of variables like severity of flat feet, age, weight, lifestyle, alignment of proximal joints etc. Thus off the shelf things are not advisable. Podiatrist is a right person to prescribe the orthotics.

     Podiatry is a branch of medicine specialized in ankle & foot problems. Podiatrist doctor will do thorough assessment of your alignment, diagnose the problem & then provide a customized solution for the same.
After certain age flat feet is not correctable but orthotic intervention can prevent further damage.

Shoe Test

Good supportive shoe are recommended for flat feet. Criteria for supportive shoes is rigid sole & firm ankle control. One should not able to twist (Torsion Test) & or bend (Flexibility Test) easily. Usually spots shoes are best supportive shoes. For the person with flat feet anti-pronatory shoes are recommended.

To strengthen foot & ankle muscles & maintain ideal weight.

Case Study


                                                                                                                    by Dr. Sarika V. Jambhulkar
                                                                                                                Consultant Practicing Podiatry

Friday, 5 December 2014

Diabetic Foot & Podiatry

Active Lifestyle
India is becoming the "Diabetes capital of the world". Currently, the number of diabetic patients in India is around 40.9 million & is expected to rise to 69.9 million by 2025. The effect of diabetes on the heart, kidney & eyes is very well known. 
So the aware population tries to adopt an active lifestyle. But they are unaware of the fact that diabetes can even affect their feet. This un-noticed complication is known as Diabetic Neuropathy, which can turn to be the biggest barrier to achieving an active lifestyle. 60 - 70 %  of those with diabetes develop peripheral neuropathy. 20% of those develop a foot ulcer.

Every 20 seconds, a limb is lost as a consequence of diabetes.

How Diabetes can hurt your feet...?

Diabetes causes two problems that can hurt your feet.
With damaged nerves, you might not feel pain, heat, or cold in your legs & feet. A sore or cut on your foot may get worse because you do not know it is there.


  • Burning, tingling sensations (worst in night).
  • Numbness or insensitivity to pain or temperature.
  • Extreme sensitivity to touch, even light touch.
  • Sharp pain sensation & cramps.
  • Loss of balance & coordination.

The second problem happens when not enough blood flow makes it hard for a sore or infection to heal.


  • Numbness & swelling in feet.
  • Coldness of legs.
  • Heaviness in legs or cramps, usually more at night.
  • Vicious Circle of Diabetes
  • Discoloration of skin.

These two problems can work together to cause a foot problem. While standing & walking certain areas of the foot are subjected to excessive pressure called "PRESSURE AREAS". These areas are prone to ulceration. Once the ulcer is developed, it causes a restriction in mobility & results in an increased sugar level. A person is trapped in a vicious circle.


All these complications can be prevented & treated with the patient's education & the help of "Podiatry Doctor"(Foot Doctor).
"Podiatry is a branch of medicine devoted to the study of diagnosis & treatment of disorders of the foot, ankle & lower limb." 
Podiatrist's aim is to improve mobility & quality of life, by following ways:
Conducting a thorough clinical evaluation of foot & lower limb.
Gait Analysis.
Foot health education regarding self-care techniques for prevention of foot pathology.
Prescribe the right size of the footwear, according to the client's foot length & width.
Prescribe customized orthotics: which help in redistribution of pressure under feet.
Non-surgical management of corn & calluses.

Key for foot health in diabetes, Keep your feet in a safe & secure environment.
Follow the instruction for better feet health.

Correcting early foot deformity to avoid chronic mobility issues thus preventing the patient from discomfort & future expense.

Role Of Podiatry to prevent AMPUTATION

Take a step in the right direction by having your feet checked regularly by a podiatrist.

Podiatry Clinic

V-Care: A Podiatry clinic  -dedicated to treating problems of foot and lower limb.
          The word podiatrist is composed of two ancient Greek parts: pod, meaning "foot," and iatrist, meaning "healer.
Podiatry or podiatrist medicine is a branch of medicine devoted to the study of diagnosis, and treatment of disorders of the foot, ankle, and lower extremity.

Here at V Care after taking history of the patients complains, a thorough bio-mechanical assessment is done. It involves observation of alignment of bones & joints, testing of muscles, assessment of walking pattern (gait analysis), their footwear and their activity level.
The purpose of a bio-mechanical assessment is not to solely identify the root cause and provide diagnosis, but to assess and explain the factors contributing to the issue. This is imperative when arriving at the inference of the best way to manage each case, as different management approach is required depending on the different factors identified. This allows all problems to be addressed leading the patients to get back their day-to-day tasks or activities.
Orthotics are devices utilized by podiatrists to address bio-mechanical issues that directly or indirectly contribute to discomfort or injury ; or as a preventive  measure for people who are deemed at risk. The level and area of support will be carefully decided by our podiatrist at V Care and is tailored specifically for individual cases.
                      In addition we at V Care perform Pediatric Assessment  of foot which involves early recognition of problems which is the key to timely intervention and  helps to prevent deterioration of the condition.