Flat Feet And What You Can Do About Them

flat feet

Do you have flat feet? If you are laying down and you look at your feet, you probably see an arch. But what happens to that arch as you stand? Does it maintain, or does it collapse. For most of us, the arch gives away. Why does this happen? In a word, shoes. Shoes are like a brace for your feet, they do the work for your arch and the muscles that support the arch get to relax and eventually atrophy. Don’t get me wrong, shoes serve a purpose and it’s not to rebuild your arch, it’s to protect your feet from broken glass and cigarette butts. 

Why is this a problem? Flat feet cause a cascade of changes up your leg and into your hip. It changes how you get out of a chair, how you lunge or go up and down stairs. These changes accrue over time and over the years, things such as meniscus tears, patellofemoral syndrome, IT band syndrome, hip bursitis, and back pain may all originate from a flat foot. Here’s how:

A flat foot is what we call “pronated” (see the right foot in the first picture). The arch doesn’t just collapse, it also causes a few degrees of rotation. So that means that your inner ankle winds back a bit, and your outer ankle winds forward a bit. This torsion changes the relationship between the shin bone and the thigh bone. On top of your shin bone sits the meniscus. Two of them actually. The torsion exposes them to the ends of the thigh bone. The patella is now moving at an angle as opposed to the straight up and down movement it is supposed to have. The attachment of the IT band inserts on the lateral part of the shin bone so now there is added tension to the IT band. These relationships are exposed with squatting, stepping, and lunging.

flat feet

As you can see in the picture, the foot collapses, leading to a caved in position at the knees. Both feet and knees are in a bad position but his right leg is worse than his left. 

Hip shear: note the angle of the belt-line. This is an example of what not to do.

Hip shear: note the angle of the belt-line. This is an example of what not to do.


In stepping down, the collapsed foot and knee lead to a shearing of the hip. This is a great way to cause bursitis. Additionally, gluteus medius is placed at a disadvantageous position causing strain. Now the QL (back muscle) is forced to compensate. Voila, back pain. 

There are two ways you can address this. You can put something under the arch such as an orthotic or “supportive shoe ware”. If you chose this route, you will rely on the orthotic or the right shoes. Or, you can strengthen the muscles of the arch. There are muscles in there that can be strengthened just like any other muscle. They are small muscles with a big job and they’ve probably been underdeveloped for a long time, so it will take persistence and diligence, It may take a year, but it will work. First off, spend a couple days a week at home just being barefoot. Draw you toes in slightly so that your arch comes off of the ground. The arch is technically non-weight bearing and should be like a suspension bridge between your heel and your toes. If you have tile floors, and you feel that cold tile on your arch, this should be a cue to change your “foot posture”. If you are in line somewhere and are just standing, focus on the position of your arch. 

There are two simple exercises you can do to strengthen the arch and should be done daily, high repetition:

ankle inversion

ankle inversion

arch raises

arch raises

Stick with it and be conscious of your foot position through the day. And please, don’t sit like this:

steph seated

 

Christopher EllisComment