The statics of hips and arches is maintained by the shape of bones and strong ligament apparatus. The muscles of feet maintain the shape, which is functionally normal, as well as the elasticity of feet. As long as the musculature is functionally good, there is the coordination of muscles, and thus functional balance, the shape of feet remains normal.  When muscles become relaxed due to illness, injuries, overload, inadequate footwear, the feet relax.

A foot examination starts with an examination of the whole body by comparing the left and right side, in particular. A number of spine, hip and knee disorders could affect foot disorders.

Anamnesis must be extensive, particularly in terms of pain, fatigue, cramps and swelling. While examining the skin colour of feet and its tension, possible oedema is sought. During palpation, the heat of skin, pulse, and possible atrophy, fibrous changes in muscle tissue are monitored.

The shape of foot is examined when it is unloaded, while sitting, and loaded, while standing.

Foot deformities can be divided into congenital (or inborn) and acquired.

Acquired static deformities are caused by the way of life, movement and work of modern people.

The changes, which occurred during the movement from the four-legged way of movement to the upright two-legged gait, are especially emphasised in the area of foot, which has become an independent organ, from the auxiliary organ for grasping, which serves to ensure standing and movement.

While humans were walking barefoot or in sandals, their feet were adjusted to the unevenness of surface, which is a vital functional stimulus for maintaining flexibility and strength. The civilisation with asphalt streets, uniform walking in flat areas, standing at work in industry, economy, hospitals, schools, banks or super markets, has led to a series of harmful consequences and so-called static deformities.

Obesity, overweight and lack of physical activity, as additional reasons for static deformities, should not be neglected.

A vast number of people suffer from a deformity known as flat feet. This deformity appears as an expression of disposition between foot strength and foot load, and they differ: lowered feet from slightly flat to extremely flat feet with the deformation of bone areas.

The feeling of heaviness, fatigue and tension in legs, foot, lower leg and thigh pain, as well as, lower back pain and the occurrence of static oedema in the feet.

Contrast baths before going to bed, according to the defined protocol, walking in nature, barefoot walking on grass or sand during the summer, corrective exercises for feet, wearing medical shoes, with the heel height of 2cm for men, up to 4cm for women. Soles should be soft and flexible and the top of shoe should be wide enough to provide the room for the movement of toes. Narrow toe boxes press toes and shorten tendons and thus transfer toes over each other and cause corns, blisters, etc.

Very special attention should be paid to the sole of kids’ shoes, which should be soft and elastic, because otherwise, short sole muscles could be damaged and the freedom of ankle movement becomes limited.

Corrective gymnastics for children is crucial, physiologically required and purposefully justified in supporting proper growth and development.

They can do those sports that strengthen muscles and do not lead to any impairment due to fatigue or increased body weight. Sports such as hiking and swimming are desirable, while skating, rollerblading, long jumps, running marathons, as well as long marches, are not recommended. Medical custom-made corrective insoles or orthopaedic shoes are recommended.

The most common deformities are heel spur, plantar fasciitis, but the largest number of people suffers from hallux valgus, a deformity, which is widely-known as “bunion”.

Bunions occur more in the female population (as much as 90%), while men often have the problems with flat feet nowadays.

The inner side of the lower half of head of the first metatarsal bone is protruded and either an inflamed mucous fistula/bag develops there or the connective tissue enlarges. As this problem progresses, the position of big toe becomes more crooked than before (sometimes even up to 90 degrees), it also becomes rigid and arthritis and sever pain often occur over time. It results in the movement of toes, so that the big toe can move under or on the toe next to it. The occurrence of bunions is completely explained medically.

Symptoms: sharp stabbing pain in the joint of big toe, pain in the sole under the first and second toe (next to the big toe), pain in the root of big toe, dull throbbing pain in the feet, pain in the heel, inability to wear any shoes due to the inflamed and swollen big toe. Such pains may cause knee, hip and lower back pain.

The application of various physical medicine procedures, which encompass the non-invasive models of therapy, is included. One of them, applied in our centre, is medical acupressure and foot massage performed by a professional. Not only that this method relieves pain and inflammatory processes, but it also monitors the progress i.e. the reduction and change of the whole big toe and foot. In addition to working on the feet, it is necessary to improve the statics and balance of the whole body in order to use it for leg and spine correction therapies. The method is non-invasive and encourages the body to self-heal and full regulation through nervous and endocrine system, until the complete correction of the skeletal and joint system. Along with the therapy in the centre, it is necessary to apply home protocols with baths and corrective exercises for the muscles of the big toe and the whole foot. Carefully-selected shoes, made of soft leather, with a heel 2-4cm, are advisable, never flat shoes! As an additional therapy custom-made corrective insoles are always recommended.

There is a scope of different views on surgical indication and there are numerous types of surgeries. Personally, I am a supporter of non-invasive methods, which can assist people in helping themselves and thus stop a process of impairment. If the process has already progressed, a surgery can be the final solution with the emphasis on the story about the consequences and postoperative course, which requires some time for the complete recovery. – explains Aleksandra Maksimović.