Flat feet or pes planus is a postural deformity relating to the collapse or flattening of the arch of the foot. It can also be referred to as the overpronation of the foot. Due to movement compensations from flat feet, people may complain of knee, hip, and lower back pain. Flat feet can be congenital (e.g. from birth) or acquired.
Congenital flat feet occurs when someone is born with either a more flexible midfoot OR rigid midfoot region resulting in pronation or collapsing of the arch.
Acquired flat feet occurs when someone develops flat feet over time. In our physical therapy office, we can help people who have acquired flat feet to develop control of their arches and restore their foot health.
There are 5-common causes of flat feet that we see regularly at our physical therapy office:
- Loss of ankle mobility
- Loss of big toe mobility
- Weakness of intrinsic foot muscles
- Weakness of hip muscles
- Lack of arch awareness
Ultimately, the reason arches flatten out over time are due to movement compensations when a lack of mobility, stability, or control is present at the foot, ankle, or hips.
If the ankle is nor flexible enough and/or the big toe is not mobile enough, the foot will compensate by spinning out during normal walking. People with flat feet typically have a "duck walk." Walking like a duck is the body's way of compensating when foot and ankle mobility limitations are present. In addition, compensations for poor ankle mobility may be observed during deep squats. People with flat feet will either spin their feet out or lift their heels as they approach a deep squat. At the bottom of a deep squat, a person with flat feet will have their entire arch on the ground.
The intrinsic foot muscles are not strong it will be very difficult to maintain a strong and stable foot. A key intrinsic foot muscle is called the posterior tibialis. This muscle may be weak in the presence of flat feet.
Hip muscles are crucial for a good foot structure. If the hips are not strong, the body will have a difficult time balancing on one leg. Since every step requires momentary balancing, the foot may compensate for flattening out to create a wider base of support during the single-leg phase of gait.
In many cases, people with flat feet have forgotten how to cue their hip and foot muscles to create a strong and stable arch. This is a skill that must be taught and practiced.
At our physical therapy office, we help people who have flat feet restore movement, develop strength, and restore their foot health.
The first step we often take in reducing pain and restoring mobility is performing hands-on manual therapy. This might include dry needling, soft-tissue mobilization, joint mobilization, or manipulation of the foot or ankle region.
However, passive treatments alone won’t provide any lasting gains in mobility. In order to develop lasting mobility, inactive muscle groups must be activated and strengthened. We have specific exercises that we intentionally use to target these regions at the foot and hips.
Once we have reinforced mobility, the next step is to work on movement and stability. We work on developing foot stability to generate tension and stiffness at the arch to prevent unwanted movement. We reinforce these concepts with single leg balance exercises.
Finally, we know that if our patients have good mobility and stability in static positions but overpronate when exercising, our rehab program isn’t very effective. We teach our patients to maintain an arch during hinge, squat, lunge, and stepping movements. When perform these movements with and without resistance so they can develop foot strength.
A thorough physical therapy assessment and plan of care should address the five common causes of flat feet. However, ignoring flat feet and continuing to move with poor mechanics can increase the risk for injury. If you have flat feet, the physical therapists at Movement Solutions would be glad to be a resource for you.
We are available for a free 15-minute phone consultation to talk about how your flat feet are affecting you and discuss your treatment options.
If you want help, we offer a limited number of free Discovery Visits at our office. This type of appointment is for those who are interested in restoring their foot health. It is an opportunity to ask questions, obtain clarity about your feet, and know with confidence that we can help you.
If you’re certain that we’re a good fit and ready to book an appointment, you can inquire about cost and availability.
If you’re unsure about what your next steps should be, call us at (864) 558-7346 and ask how we can help.