However, there are times when flat feet can cause some medical problems, ranging from pain to fatigue and more. This is because the arches in our feet are natural shock absorbers. They hold your body weight and act like a spring to propel you forward while you are moving.
Those working in professions that require being on one’s feet all day long are particularly susceptible.
In addition, athletes with flat feet can also develop problems related to not having a strong and healthy arch.
Luckily, there’s help out there for those who want it. Depending on the type of flat feet that you have, medical professionals can even work with you without resorting to invasive surgery. By strengthening certain muscles and connective tissues, simple exercises can create more of an arch in your foot.
Not all flat feet are created equal.
There are two types of flat feet: rigid and flexible.
Rigid flat feet are very rare, affecting approximately 2 – 3% of the population. This is a serious medical condition characterized by structural deformities of the foot. Severe injuries or illnesses such as Cerebral Palsy or Down’s Syndrome can cause them to form. Most cases of rigid flat feet are hereditary. In these situations, surgery is only the way to resolve the problem.
However, most people have flexible flat feet. Also known as fallen arches, it affects about one in four people. This is a condition in which the foot has little to no visible arch, forcing the sole of your feet to make full contact with the ground when standing up.
How to tell if you have flexible flat feet
A wet surface test is a common and reliable way to test whether you have flat feet. Instructions are as follows:
- Pour enough water into a container so that your foot is fully submerged inside the liquid. You can add food coloring to improve the results.
- Place a blank piece of paper next to you.
- Dip the soles of your feet into the container to make them wet.
- Stand on top of the paper.
- Step off and check the results.
How pronounced the lack of arch is depends on multiple factors ranging from you musculoskeletal structure, biomechanical elements, to posture.
Yet, believe it or not, you do actually have an arch – no matter how low – even if you technically have flat feet. To see this yourself, simply perform a tip-toe test. Stand on your feet and push yourself off the ground with your toes and front portion of your feet only. As your feet extends, the arch will gradually grow more visible.
Is Having Flat Feet Bad?
We get this question a lot and the answer is that it depends.
Our feet are very complex and fragile, consisting of twenty-six bones, thirty-three joints and more than one-hundred muscles and connective tissues. They also contain a myriad of blood vessels and nerves. When you add in lifestyle factors, it’s easy to see why diagnosing and treating foot problems can be complicated.
Those with flat feet usually don’t experience symptoms. As aforementioned, many go on living their lives without any problems at all. If you experience no pain or discomfort while being active on your feet, there is little to be concerned about.
However, having flatfoot can predispose you to some medical problems. This is especially true in adulthood.
Foot arches are there to act as a spring on your feet, helping stabilize and support you. When you have flat feet, other parts of your legs, ankles and knees are forced to overcompensate by helping carry the load a healthy arch would.
“Flat footedness in asymptomatic patients also caused pronounced changes in kinetics. Interestingly, they needed to absorb about 40% more ankle joint energy during ground contact than normal feet. Consequently, foot function in asymptomatic flatfeet is already compromised when walking,” explains Matthias Hösl from Orthopedic Hospital for Children in Aschau, Germany.
Lacking arches in your feet also adds additional stress on the posterior tibial tendon, which supports the arch of the foot.
So what caused you to have flat feet and what can you do about it?
In the beginning, everyone started with flat feet.
All babies are born with the flat feet, which can worry parents unfamiliar with this fact. Indeed, a 1957 British Medical Journal study illustrates that all two-year-olds had flat feet.
Babies have a padding of fat on the sole of their feet which masks the undeveloped arch beneath it. As they grow and develop, the foot will start to strengthen from walking and will culminate in a functional arch. Most kids will develop the arch in their foot by the age of six, according to the American Academy of Pediatrics. However, about 20-25% of children will fail to develop an arch by adulthood.
There are some studies [link to barefoot section] revealing a correlation between footwear and the prevalence of flat feet in children. Some speculate that wearing modern shoes actually prevents foot arches from forming by weakening the supporting muscles and other connective tissues in your lower legs. However, there appears to be a lack of sufficient evidence to support this theory.
It’s also possible to develop fallen arches as an adult. This condition is known as acquired adult flat feet. Here are
Six common factors of adult flat feet
- Age: This is especially prevalent in the elderly population (60+) who are sedentary. Inactivity can cause their arches to collapse.
- Being overweight: An arch is a natural shock absorber in our feet, designed to bear the weight of your body. Being overweight will add stress not only onto the arches but throughout your body including your knees, ankles, hips and more.
- Long-distance runners: Flat feet can develop in athletes, especially those specializing in long-distance running like marathons. The Journal of Foot and Ankle produced research revealing that the arch height of runners decreased after a half-marathon.
- Pregnancy: Developing flat feet is a common problem in pregnancy due to weight gain. A study conducted by the University of Iowa illustrates pregnant women experienced significant and permanent decrease in arch height.
- Diseases like Cerebral Palsy, arthritis and diabetes are known to cause the arch to collapse, resulting in flat feet.
- Injuries to muscles and tendons that link to the foot arch, such as the tibialis posterior that supports the arch.
What about overpronation?
Overpronation is a term often mistakenly used interchangeably with flat feet, but they are not the same.
Overpronation is a word used to describe a biomechanical dysfunction affecting your ankles and knees when you walk, run and jump.
If you see someone walking and you can tell their feet are rolling inward, then they have overpronation. This will cause the ankles and knees to misalign, adding stress to your legs, hips and lower back.
Overpronation can occur in people with both flat feet and those with high arches.
Sometimes what appears to be flat feet is actually overpronation. Simply having your feet rolled inwards will lower your arches. This explains why some flat feet to magically “disappear”. The subject learned to correct their overpronation by fixing their posture and gait mechanics.
How Shoes Can Help with Flat feet
Changing one’s shoes is often the first piece of advice podiatrists and physical therapists will give to those in pain because of their flat feet. Arch-supporting shoes are designed to artificially raise the collapsed arch, lightening the load placed on your feet, legs and even all the way up to your back.
If you experience pain related to your flat feet, proper footwear can lessen the discomfort you experience while active.
However, there is no one-size-fits-all solution when it comes to finding a proper footwear.
For instance, motion control shoes are recommended because they are designed to fix the overpronation that can also accompany a flat foot. Yet before you buy them, take note of this study:
A 2011 British Journal of Sports Medicine concludes that simply assigning motion control shoes to correct pronation did not produce expected results. In fact, the group that wore motion control shoes experienced greater pain.
“You can’t simply look at foot type as a basis for buying a running shoe,” states Dr. Bruce H. Jones, who authored of the military study that produced similar results in U.S. Army’s Public Health Command.
Picking the right shoes for flat feet requires knowing more than just your feet type. You also need to consider other factors like your gait, level of pronation, and intended activities. Refer to our guide on how to pick the best shoes for your flat feet.
Can Orthotics Help?
It depends on the individual. While it helps many who suffer from pain caused by flat feet, there are others who found little to no relief.
Foot orthotics are designed to mechanically fix the imbalances in one’s musculoskeletal structure, much like the arch-supporting shoes. It works by artificially providing an arch for those flat feet, thereby causing some pain relief.
The benefits of wearing the right orthosis well-studied and observed. A study published by the Current Opinion in Rheumatology reveals shoe insoles can have a positive impact by reducing the stress on your joints.
However, not all researchers agree how exactly foot orthotics help those with flat feet.
“Shoe inserts may be helpful as a short-term solution, preventing injuries in some athletes. But it is not clear how to make inserts that work. The idea that they are supposed to correct mechanical-alignment problems does not hold up,” said Dr. Nigg of the University of Calgary, who has studied the efficacy of foot orthotics for over thirty years.
To make this method work for you, you need to make sure you pick the right orthotics for your specific needs.
Podiatrists are quick to prescribe costly custom orthotics. Yet there are virtually no scientific evidence that shows they are any more effective than over-the-counter orthotics. The only reason to consider custom ones is if you cannot find a comfortable fit with prefabricated insoles for your flat feet.
Exercises to Fix Flat Feet and Form Healthy, Functioning Arch
“Fixing” flat feet entails strengthening the arches and lifting them off the ground with a combination of exercises and stretches.
You can improve most cases of flexible flat feet by performing exercises that are designed to strengthen the muscles and connective tissues in your foot. This will in turn raise the arch. These exercises are designed to fix the biomechanical issues that are causing your arches to collapse and fall.
Although proper footwear and orthotics can work for many individuals, they are short-term solutions. Strengthening and creating a natural arch in your foot is possible and a recommended long-term solution for those having problems with their flat feet.
Below are four exercises you can do increase the height of foot arches. It’s important to consistently practice these. Most of these exercises can be done while watching TV so try to incorporate them into your daily activities.
Spend at least 10 minutes a day, 3 to 4 times a week. The results will take time but most who consistently do these exercises see results in as little as 8 weeks.
- Strengthens the intrinsic muscles in your feet. 1) Sit or stand, placing your feet parallel to each other on top of the towel and in neutral stance. 2) Curl your toes to create a grabbing motion on the towel. When done successfully, the towels will start scrunching up towards you, 3) Next, push the towel away from you with your toes, flattening out the towel again. Make sure your heels stay in contact with the towel at all times. Perform 2 sets of 10 repetitions.
Standing Calf Raises
- Calf raises are excellent for developing a strong calf, which helps your ankles and your feet flex. The exercise will also improve the strength of various muscles and other connective tissues in your feet, including the arches. 1) Place the front portion of your feet (the toes and front of the balls of your feet) on top of a thick material. Phone books are excellent for this. 2) Support yourself by balancing yourself with your arms on the wall. 3) Slowly and gently lift yourself straight up towards the sky by lifting your heels off the ground and pushing off with your toes. Do 2 to 3 sets of 10 calf raises. If this is too hard, you can perform the exercise while seated.
- By articulating (?) your toes, you will recruit various intrinsic muscles and connective tissues on your feet. Here is an excellent routine that can be done in under 3 minutes: https://www.youtube.com/watch?v=G-PUaaqsjnI
Hip Flexor Stretch
- Most people, especially those with flat feet, have tight hip flexors that limits the range of motion, pulling on various parts of your lower body including the arch of your feet. This often results in what’s called Anterior Pelvic Tilt (also known as Donald Duck Syndrome), causing problems to many parts of your lower extremities, including shortening your arch. There are many variations to this stretch. The easiest for a novice is the Butterfly Stretch. 1) Sit down on a padded area like a yoga mat or a carpet. 2) Move the soles of your feet together. 3) Slowly drive your knees downward. You should feel the stretch in your thighs and in your hips. Hold for 20 seconds. 4) Release and repeat 5 times. Make sure to sit straight up and do not round your back while doing this. https://www.youtube.com/watch?v=rdxD3POKbV8
Case for, and against, going Barefoot
Our feet are not naturally evolved to fit inside cramped shoes with ample “arch support” that promises to relieve all the pain and pressure.
It is often argued that modern shoe have weakened and atrophied the tissues that support the proper formation of arches in one’s foot.
Two studies reveal a correlation between wearing shoes and having flat feet:
- The Journal of Bone and Joint Surgery published a paper in 1992 revealing that the children who wore shoes were three times more likely to end up with flat feet. The study concluded that footwear can hinder the development of foot arches in children.
- In 1905, Dr. Phillip Hoffman presented a study that associated higher incidents of flat feet with those wearing shoes.
In addition to these two studies, many people report they have “fixed” their flat feet by and its accompanying symptoms by going barefoot.
Some speculate that foot orthotics and specialized shoes…
can gradually weaken muscles, tendons, bones and ligaments that naturally support your arch. This causes a cycle where you are stuck with a weakened arch, with no hope of ever training your muscles to develop a healthy and strong arch.
However, there is no scientific evidence to back up this theory – although there are ample facts to back up shoes and orthotics. [6. Tomaro J, Burdett RG. The effects of foot orthotics on the EMG activity of selected leg muscles during gait. J Orthop Sports Phys Ther 1993;18(4):532–6.
7. Mundermann A, Wakeling JM, Nigg BM, Humble RN, Stefanyshyn DJ. Foot orthoses affect frequency components of muscle activity in the lower extremity. Gait Posture 2006;23(3):295–302.]
“Barefoot running does not result in greater activation in these muscles compared to running shod. This suggests that barefoot running may not result in strengthening of the foot intrinsic muscles. Passive structures and extrinsic foot muscles may play a greater role in controlling foot motion than intrinsic foot muscles during running,” said the American College of Sports Medicine in 2012.
Thus, the jury is still out on this one. While many say going barefoot can help, the lack of evidence makes it difficult to seriously consider this as an option.
Flat feet surgery should only be considered as a last resort, reserved for extreme cases. Flat feet reconstruction surgery is highly invasive and the recovery process is both painful and long. From exercises to better shoes, there are many other things you can try before resorting to such a risky operation.