Monday, 23 August 2010

Flat Feet (or Pes Planus)

Lately I have had quite a few people ask me about flat feet.

Flat feet (or pes planus), is a condition where the arch of the foot is collapsed. This results in the sole of the foot being in partial or complete contact with the ground surface. Flat feet may occur unilaterally (one side) or bilaterally (both sides).
Flat foot

It may be common for young children to have flat feet, as their skeleton and musculature are still developing. Infant flat feet usually resolve by itself over time and normal arches start to develop from 4 years of age and onto adolescence. It is however important to monitor your child's walking as time progresses, looking out for excessive clumsiness, odd patterns of walking, or complaints of heel/foot/lower leg pain.

Adult flat feet can be caused by a number of factors, including:
  • Faulty lower limb biomechanics
  • Incorrect walking/running/sporting techniques
  • Poor footwear (regular use of flat ballet type shoes, high heels, shoes with no arch or improper sole)
  • Prolonged stress/pressure to the foot
  • Injury
  • Pregnancy
It is common for people with flat feet to over-pronate their foot (roll inwards) as they walk, and also complain of plantar fasciitis (an inflammatory condition of the plantar fascia, causing heel pain most notable first thing in the morning). Some adults may have flat feet without any symptoms; however once symptoms present, it is important to seek a physiotherapist or podiatrist's advice to work out the source of the problem and be treated appropriately.

Depending on the cause of flat feet, some treatment options include:
  • Taping to support the arch and reduce pain
  • Orthotics (does not have to be custom-made, chemist ones are equally as good and cheaper)
  • Physiotherapy for strengthening and proprioceptive exercises to retrain the muscles of the foot and ankle
  • Correction of lower limb biomechanics (require assessment of the knee/hip/pelvis by a physio to assist with rehabilitation)
  • Correction of walking/running/sporting techniques (by sports trainer or physio)
  • Improve footwear 

More questions?
If you have any further questions or would like to be referred to a specialised physiotherapist, contact us.



    "How do i fix it?

    what exercises/stretches help you correct it?
    I've heard you could roll up a towel with your feet or doing calf raises to strengthen the muscles around the area.

    what else?"

    For flat feet, you can do some exercises to strengthen the arch/intrinsic muscles of the foot. Curling your toes on the floor (and raising your arch) is a good one to start with, and then progress to curling your toes over a towel and trying to pick up the towel with your toes. It is also important to stretch your calf muscles to ensure that they are not tight which can affect your walking too.

    For plantar fasciitis, in addition to the above intrinsic strengthening exercises, you should also stretch the plantar fascia by pulling back the toes so that it stretches the sole of your foot. You should be able to feel a tight band along the bottom of your foot as your stretch. Hold for about 15 seconds, repeat 2-3x. Then perform your calf stretches.

    It is also important to practise balance and proprioceptive exercises, eg. standing on one foot over a cushion to train the ankle stability, or practise standing on a wobble board.

  2. Hi Roberta,
    What footwear do you recommend to improve flat feet? Any particular brands or styles?