Condition
Pronated feet, fallen arches and splayfoot in adults
The same shoes used to fit without difficulty. Now your forefoot feels squeezed, your arch tires or a longer walk becomes uncomfortable. Perhaps the German term ‘Knick-Senk-Spreizfuß’ has appeared on your prescriptions for years, without you knowing exactly which change it describes in your case.
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Understanding
A closer look
We want to work with you to establish your foot shape, whether it explains your symptoms and what support could actually help. A foot shape that differs from an idealised illustration does not automatically mean there is a medical problem or that treatment is needed.
Three terms for different changes
A lowered arch means the inner longitudinal arch has flattened; marked flattening is also called flatfoot. In a valgus foot, the hindfoot alignment changes, often together with a lowered arch. In a splayfoot, the forefoot widens, which can change the load beneath the metatarsal heads.
These changes may occur together, but do not necessarily share the same cause or significance. Some people manage well with such a foot shape for years. Others develop tenderness to pressure, calluses or difficulty walking. The label alone does not tell us which insole or exercise suits you.
When a change should be examined more closely
A new or increasing change is particularly important, for example if the arch drops noticeably on one side or pain develops around the inner ankle. Tendons and ligaments help guide the foot, so their function is also assessed. A changed walking pattern should not simply be accepted as a normal part of ageing.
A wound, pronounced redness or rapid swelling needs prompt assessment. This is particularly important with diabetes or reduced sensation. A suddenly hot, swollen foot can be urgent even if it barely hurts. Do not wait for a routine insole appointment for changes like these.
Further information
How we assess the foot in context
We look at your feet while you stand and move, assess mobility and, depending on the findings, the function of the tendons involved. Whether a deformity remains flexible or is already largely fixed also matters. The skin and any pressure areas provide further clues.
The shoes you wear regularly and your existing insoles are useful for this assessment. We want to know when symptoms occur and whether you can actually wear the support provided. For specific questions, X-rays, sometimes taken while weight-bearing, add to the examination. Imaging or an equipment-based measurement is not essential simply because the term ‘Knick-Senk-Spreizfuß’ has been used.
What shoes and insoles can do
Suitable footwear can provide room and help you stand steadily. An insole can distribute load, relieve particular areas or guide the foot. Whether this is useful, and in what form, depends on your symptoms. A more expensive aid is not automatically more effective.
A more pronounced deformity or reduced tendon function may require greater support. Equally, not every symptom-free foot shape needs an aid. It remains important to check together: is walking easier? Are new pressure areas developing? Does the insole actually fit the shoes you need in everyday life?
Movement is part of the decision too
Where appropriate for the findings, exercises for strength, mobility and coordination can form part of treatment. These exercises cannot simply reshape a fixed bony deformity. Nevertheless, functions that can be trained may matter for your capacity for activity.
We do not want to attribute all knee, hip or back pain to your foot shape as a general rule. Symptoms in several areas are assessed individually. A helpful treatment plan states what the specific measure for the foot is intended to achieve and how we will recognise its benefit. Support without such a goal often proves unsatisfactory in daily life.
When current support is not enough
If significant symptoms persist or a deformity progresses, we check whether the diagnosis and support remain appropriate. Sometimes assessment by a foot surgeon is useful. The decision depends on function, the condition of tissues and joints, and the options for aftercare.
Your description of the problem is enough to begin with at the appointment. You are welcome to note when your foot shape began to change and which walks have become harder. You do not need to decide yourself whether a lowered arch, tendon problem or another finding is responsible.
Frequently asked questions
Does every lowered arch need insoles?
No. Symptoms, function and risk determine the need. Foot shape alone does not justify every type of support.
Does an insole permanently correct foot shape?
It can provide support while you wear it and change how load is distributed. This does not generally mean it permanently corrects the anatomy of an adult foot deformity.
Should I bring my existing shoes and insoles?
Yes. This allows us to assess together what works in daily life and where space, fit or pressure relief are insufficient.
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