Choosing an orthotic that supports all of the arches of the foot

There are two other arches in the foot that need support as well — together, they make up all of the arches of the foot, called the plantar vault

When talking about the arches of the foot, we are generally referring to the medial longitudinal arch. This is the arch that extends from the base of the big toe to the heel and, if not sufficient, can lead to issues higher in the body.

For example, a study published in the journal Arthritis Care & Research indicates that individuals with flat feet have a 1.3 times greater incidence of knee pain in their later years. They also have a 1.4 times greater chance of developing medial tibiofemoral cartilage damage.

Another piece of research, this one published in Gait & Posture, looked at flexible flat feet and the impact on children’s joints. After studying 95 children between the ages of 8-15, researchers noted that reduced arch height was correlated with the presence of symptoms not only in the knees but also in the back and hips.

Foot orthotics are one tool for correcting this particular arch. However, there are two other arches in the foot that need support as well. Together, they make up all of the arches of the foot, called the plantar vault.

The plantar vault and the arches of the foot

Think of the bottom of the foot as a triangle, with one dot at the base of the big toe, one at the base of the little toe, and one at the heel. Draw a line between each dot and you have the plantar vault, which consists of three arches:

• The base of the big toe to the heel is the medial longitudinal arch
• The heel to the base of the little toe is the lateral longitudinal arch
• The base of the little toe to the base of the big toe is the anterior transverse arch, also sometimes referred to as the transverse metatarsal arch

These three arches work together to provide the body better balance. They also give the support necessary to propel the body forward, such as when walking or running, and adequately adapt to the stresses of being on our feet.

It is common for at least of these arches to weaken with age. Sometimes two or all three begin to fall due to constantly fighting against gravity. Suffering an injury can also lead to weakened arches. When this occurs, it places more pressure on the other arches and the effects can be felt body-wide.

The anterior transverse arch

The idea of an anterior transverse arch can be found in research as early as 1894. In an article written by Joel E. Goldthwait, MD, the doctor shares that while this arch is smaller and sometimes less important, issues with it can lead to pain and dysfunction. Additionally, this arch being flat is more common than having a flat longitudinal arch.

A February 2020 article agrees with the doctor and states that the transverse metatarsal arch not only exists but also controls more than 40% of the foot’s stiffness. Researchers further state that understanding the arches of the foot may be the key to effectively treating flatfoot disorders.

Longitudinal arch and gender

It should also be noted that some pieces of research have found that certain gender-based differences tend to exist with regard to the arches of the foot and functionality.

One such study was published in the March 2012 edition of The Foot. Radiographic images were obtained from each participant — 11 males and 8 females — both with and without weight bearing. Subjects also performed a single-leg landing with the knee extended, with images captured during the landing.

Females had significantly greater angles in their medial and lateral longitudinal arches than males when in a weight-bearing position. They also experienced a higher level of angular changes, suggesting a greater range of arch motion.

Recognizing that the foot has three arches is necessary to choosing an orthotic that adequately supports all three arches of the foot, providing the patient a higher level of correction and comfort.