Flat feet are commonly seen in today’s society and can be problematic for some individuals because it can cause pain, dysfunction, or even a decrease in optimal performance and power output in athletes. There are many causes of having a flat foot, ranging from genetics, strength and shoe wear. In my experience, I find that genetics has the smallest influence on the foot of the factors listed above.
I find that shoe wear can be a huge contributor to a flat foot, especially those that notice their foot has become flat in their adult life. Almost all shoes that are made today have a slightly higher heel on them then the front of the shoe (as seen below).
This causes the foot to be in a constant state of plantar flexion which will cause you to lose your dorsiflexion mobility. Dorsiflexion is vital to foot health and is needed to walk and squat. When you have a limitation in dorsiflexion the foot will pronate, or flatten, to gain more range of motion in activities like walking, running and squatting. This repetitive motion over time will result in static posture of a flattened arch. Another aspect of footwear that can affect the arch is the wearing of long term orthotics. Many children, teenagers and adults are prescribed orthotics to help with foot pain. I find that this can make the problem worse if they are worn for long periods of time. Orthotics are made to support the foot and create an arch. The orthotic allows the foot intrinsics and tibialis posterior (muscle responsible for holding up the arch) to relax as they do not have to work to keep a stable arch because the orthotic has taken this job. Just as a corset will cause the core muscles to atrophy, orthotics may cause the foot muscles to atrophy. If you rely on orthotics and use them daily, this may be the cause of your foot pain and flat arch.
There are many techniques that you can employ to help fix your flattened arches, but if your arch has been flat for a long period of time then it will take time to reverse the effects. The first way to begin to fix this problem is by changing your shoes. If possible, try to get shoes that have no heel on them. If you continue to wear shoes with a slight heel then no matter how much you stretch you will always have limited motion. Try wearing shoes like this that are flat:
After changing your shoes, you can start stretching to increase your mobility. A simple calf stretch that can be done is to stand with your toes on a step or curb and lower your heel down as far as you can. You should feel a stretch in the calf musculature or the achilles region. Make sure to hold the stretch between 30-45 seconds. Continue to do this stretch 2X daily until you notice a significant change in your range of motion.
Along with stretching you should also begin to strengthen the intrinsic foot muscles. A good exercise to start with is a towel curl. This is done by placing a towel on on a smooth surface and curling your toes to bring the towel closer to you. Repeat several times until the towel is fully scrunched and then start over again. Another great exercise to do is a heel raise with a ball between your ankles near your heels. While holding the ball firmly between your ankles, do a heel raise and then repeat. Make sure to actively squeeze the ball and keep the heel lined up with the big toe. This activates the tibialis posterior and helps to keep good alignment of the foot during the exercise. Orthotics are okay to wear for short term if you are in pain, but once you have built good strength in the foot muscles to support your arch you should stop wearing the orthotics. I also recommend walking barefoot, when you can, to teach your foot muscles to support yourself. It is important to build strength in the foot musculature instead of relying on an orthotic or overly padded shoe to do it for us. If you have any questions, make an appointment with a physical therapist to address your problem.
Jordan Cardoza PT, DPT, CSCS
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