Patellofemoral pain is believed to be caused by abnormal tracking of the kneecap and can be the result of a number of factors including muscle tightness, weakness and "overuse". Individual anatomical factors and improper equipment fit also contribute to PFP. Overuse" simply refers to "doing too much too soon" or continually performing a movement or activity the body or body part isn't prepared for. When the physical demand is greater than tissue tolerance without adequate recovery, inflammation, pain and injury often results. This applies to any repetitive activity as well as sports and training. An 'orthotic' (orthotic insole, shoe insert or orthosis) is a device placed inside the shoes with the purpose of restoring our normal foot function. Different types of foot orthotics are available, from special custom-made devices (prescribed by a Podiatrist) to so called ‘off-the-shelf’ orthotics which can be purchased from pharmacies, good quality shoe stores or specialty websites. Orthotics correct the problem of over-pronation and they re-align the foot and ankle bones to their neutral position, restoring our natural foot function. In turn, this will help alleviate problems not only in the feet, but also in other parts of the body! Unlike the old designs whereby they would come being big and with high heels, they are now designed in the most fashionable styles. They are now found in all cuts and can even be made into safety shoes. But they still address the condition of the person wearing them. They are available for the young, old, males and females. Flaccid feet occur when there is complete paralysis of the foot muscles. Sometimes surgery is able to restore the foot to its fully functioning state. Occasionally non-surgical treatment is recommended by a doctor that includes orthopedic inserts and foot exercises designed to regain foot mobility. Flat feet (also called pes planus or fallen arches ) is a formal reference to a medical condition in which the arch of the foot collapses, with the entire sole of the foot coming into complete or near-complete contact with the ground. In some individuals (an estimated 20–30% of the general population) the arch simply never develops in one foot (unilaterally) or both feet (bilaterally). Fallen Arch" Health A to Z Aetna InteliHealth(R). 2007-12-18 Retrieved 2008-05-27 "Unlike a flexible flatfoot, a rigid flatfoot is often the result of a significant problem affecting the structure or alignment of the bones that make up the foot's arch." In addition to issues in the foot, the ankle and lower legs can be affected by flat feet and fallen arches. Tendinitis mainly affecting the Achilles tendon can cause ankle pain and foot pain. Swelling and inflammation of the tendon may require therapy and surgery to address the pain. In the lower leg, active people with flat feet may experience shin splints. The condition occurs when the lack of an arch causes inflammation in the bones of the lower leg. Excessive pain in the shin can be caused by flexion and extension of the foot. Flexible flat foot is considered pathological when pain is present in the arch and persists despite proper conservative method. In addition, callosities and abnormal shoe wear are sometimes indications for surgery. Rarely, should surgery be performed before skeletal maturity. A variety of tendon transfers and reconstructive procedures have been advocated, but none have proven uniformly successful. Operative intervention to create an arch by blocking subtalar movement may establish an arch but may damage the subtalar joint and cause degenerative arthritis in adult life. Fusion of the subtalar joint alone or a more extensive procedure, such as a triple arthrodesis, is indicated for severe persistent pain.