Calluses are an issue with many people, but people suffering from flat feet may have foot pain from calluses that form due to the constant rubbing of the foot against the inside of the shoe. Although there are shoes that address the issue of flat feet, ill-fitting footwear may also cause bunions to form. Due to the lack of an arch in the foot, pressure at the base of the great toe may cause the joint to enlarge, causing foot pain. Muscle weakness caused by flat feet may also allow toes to curl into a claw-like position referred to as hammertoe. There are two different kinds of flat feet If you have a rigid flat foot, that means that the foot is flat regardless of whether you are sitting or standing. Those with a flexible flat foot will have a bit of an arch when they are sitting down, but that arch disappears when the person stands up and puts weight on his feet. This can lead to ankle and foot pain as well as leg, hip and knee pain. Individuals with rigid flat feet generally experience more problems and symptoms. In some cases the physician may order an X-ray, CT (computed tomography) scan, or MRI (magnetic resonance imaging) scan. The arch which goes across the foot below all the toes can drop as we get older so making the foot wider. If it drops substantially hard skin can develop on it too. Use a foot file, like a large emery board to remove this. People often think it is easier to remove hard skin after a bath when the feet are soft. It is actually better to do it before a bath as you will be able to monitor how much you remove easier. Always leave a little hard skin. It has developed to protect our feet and if you remove it all your feet will be sore. Identifying pes cavus is a straightforward process. The high arched foot is noticeable to anyone, but an orthopedic surgeon should evaluate the individual in order to identify some of the nuances of the condition. Diagnosing which muscles are tight or weak and assessing their potential to be stretched or strengthened is important for initiating an effective treatment plan. Also, the cavus foot causes increased body weight to be distributed through areas of the foot that are not designed for this purpose. Evaluation by the surgeon will aid in a proper prescription of orthotics, if deemed necessary. The most direct way to influence your foot health and function is with your shoes and orthotics. The American Academy of Podiatric Sports Medicine advises runners who are overpronators to wear running shoes classified as either "maximum stability" or "stability." These shoes include asics gel-fortitude and new balance 850, and they provide adequate arch support, cushion and help stabilize foot movements. Because shoes are not custom-made, orthotics can provide additional support that is specific to your needs. Semi-rigid orthotics are recommended because they support your arches, improve gait efficiency and prevent further deterioration of your arches, according to a 2004 article in the "British Medical Journal." Training errors are usually related to doing too much too soon and apply to the frequency, duration or intensity of training or activity (or any combination thereof). Too much stress without adequate rest will fatigue the plantar fascia beyond the ability of the body to repair it and injury will result. Proper footwear designed to meet the specific demands of an activity is important for the purpose of support and shock absorption to reduce excessive pronation. Various muscles of the foot, ankle, thigh and hip influence the mechanics of the foot and if tight and/or weak can cause excessive pronation. If flat feet are acquired (have not always been flat), you should start by trying to determine what is causing this change. It is quite common for flat feet to be caused by excessive muscle stiffness in the calf muscles or weakness in the hips. If the foot is being forced flat or allowed to become flat because of muscle stiffness or weakness further up the leg, those areas need to be addressed first. Remember, if an insole is placed in one shoe, be sure to put one in the other as well to maintain balance. Hypotension and renal failure are both serious conditions that you will need discuss with your doctor. Hypotension, or low blood pressure, can cause symptoms such as fainting or dizziness and can signal that you have a serious cardiac or neurological problem. Severe hypotension can deprive the organs of the necessary blood and cause shock. According to a 2008 issue of Nephrology Dialysis and Transplantation, studies found that renal failure, where your kidneys cease working and electrolytes and waste can build up in your body at dangerous levels, is usually preceded by an episode of hypotension. During orthotic evaluation, the patient might verbalize that he or she has been experiencing pain on the medial aspect of the ankle, secondary to the stretching of the medial ligaments and soft tissues. Severity of valgus angulation should be measured and the orthotist should note if medial edema is present from repetitive stretching and traumatizing of the area (Figure 1a , Figure 1b , and Figure 1c ). If the patient is progressing, pain will develop laterally as the fibula impinges on the calcaneus. Muscle testing inversion strength and single-limb heel rise are helpful in determining severity of the problem as well as in developing the orthotic plan.