What is the primary goal of orthotics in the treatment of flexible flatfoot?

What is the primary goal of orthotics in the treatment of flexible flatfoot?

• A. Control the amount of hindfoot valgus in flexible flatfoot.
• B. Correct the arch height completely.
• C. Increase hindfoot varus.
• D. Limit subtalar motion entirely.

Answer: (A)

The primary goal is to control hindfoot valgus during weight-bearing. In flexible flatfoot, the hindfoot tends to evert and the arch collapses under load, leading to excessive pronation. Orthotics are designed to bias the hindfoot toward a more neutral position by providing medial arch support and a rearfoot post that limits calcaneal eversion, which in turn reduces abnormal subtalar motion during stance and improves load distribution through the foot. This approach addresses the functional problem—excessive pronation—without forcing complete arch height restoration or locking the foot. Increasing hindfoot varus or entirely limiting subtalar motion would disrupt normal gait mechanics, so they are not the primary aim. Therefore, the best answer is to focus on controlling hindfoot valgus.

The primary goal is to control hindfoot valgus during weight-bearing. In flexible flatfoot, the hindfoot tends to evert and the arch collapses under load, leading to excessive pronation. Orthotics are designed to bias the hindfoot toward a more neutral position by providing medial arch support and a rearfoot post that limits calcaneal eversion, which in turn reduces abnormal subtalar motion during stance and improves load distribution through the foot. This approach addresses the functional problem—excessive pronation—without forcing complete arch height restoration or locking the foot. Increasing hindfoot varus or entirely limiting subtalar motion would disrupt normal gait mechanics, so they are not the primary aim. Therefore, the best answer is to focus on controlling hindfoot valgus.