There is a classic pattern that is found in relation to leg biomechanics and knee pain. Frequently a flatter foot allows the tibia or shin bone to rotate inward. If the muscles of the lateral hip are not strong, this shin rotation will result in femur or thigh rotation. This internal rotation between the shin and the thigh creates increased twisting stress on the knee, frequently leading to pain. The Arch Height Index which is calculated as the ratio of the dorsum of the foot (at 50% of foot length) to the truncated foot length has been shown to have good intra-tester and inter-tester reliability 11 While some children experience delayed growth due to medical issues, most children will grow to a genetically predisposed height by the time they are adults. The rate at which they will grow varies from child to child and may be influenced by environmental factors as well. While there is no way to artificially make a child grow taller, certain steps will help your child’s height increase at a normal, healthy pace. Always consult a doctor with any questions about your child’s growth. People who sit at a desk all day often experience back problems, and one frequently suggested solution is to use an exercise ball instead of a desk chair. Flat feet (or pes planus) , is a condition where the arch of the foot is collapsed. This results in the sole of the foot being in partial or complete contact with the ground surface. Flat feet may occur unilaterally (one side) or bilaterally (both sides). usually resolve by itself over time and normal arches start to develop from 4 years of age and onto adolescence. It is however important to monitor your child's walking as time progresses, looking out for excessive clumsiness, odd patterns of walking, or complaints of heel/foot/lower leg pain. To understand what flat feet are, it is necessary to have a little background of the functional anatomy of the foot. The foot may be divided into three main parts, namely the forefoot , the midfoot and the hindfoot. The forefoot consists of the toes (phalanges) and the thin longer (metatarsal) bones connected them. The midfoot consists of the 3 cuneiform, the cuboid, and the navicular bones, which form the medial longitudinal arches of the feet. The hindfoot consists of the talus bone which supports the leg bones and forms the ankle, and the calcaneus bone which forms the heel of the foot. You are more likely to have flat feet if the condition runs in your family. If you are highly athletic and physically active, your risk is higher due to the possibility of foot and ankle injuries. Older people who are prone to falls or physical injury are also more at risk. People with diseases that affect the muscles—for example, cerebral palsy—also have an increased risk. Recognizing the Symptoms Flat feet tend to be a hereditary condition and is usually not preventable. You can prevent the condition from worsening and causing excessive pain by taking precautions such as wearing shoes that fit well and provide the necessary foot support. Since the problem tookplace over a long period, it will also heal over a long period.Tendons and ligaments have poor blood supplies and do not healfast once injured. The good news is that if you can take all thepressure off, the body does have a memory and often willre-absorb the extra bone that was laid on over time. In extremecases, a surgeon may have to remove the spur, but most doctorsare extremely reluctant to do any surgery, preferring to useshoes and arch supports to manage the problem. Most doctorswill not elect to ever do surgery on this area. Flat feet in themselves are not a problem. But running on flat feet is almost like running on gelatin. Flat feet turn inward (overpronation * ), causing legs to turn inward, and contribute to such "overuse" injuries as shin splints and back problems. Flat feet also can produce heel spurs * If pain develops as a result of any of these conditions, flat feet and the problems they cause need treatment. During World War II, young men who had flat feet were disqualified from military service because it was believed they could never make it in the infantry. Casting and immobilization. This is a last conservative treatment option for managing patients with symptomatic flexible flatfoot, and is typically most commonly indicated for patients with posterior tibial tendinitis. However, treatment of acute cases of posterior tibial tendinitis (or tendinopathy) may begin with immobilization, followed by other conservative measures such as those listed above once inflammation is resolved. Nonetheless, the purpose of casting is to remove the strain placed on the posterior tibial tendon. Ideally a short-leg nonweightbearing cast provides the most ‘rest’ to the tendon. Some patients are better managed in a walking cast and this depends on the severity of the tendinitis. Surgical management.