All about
Flat Feet
If you have flat feet, your feet will be flat on the ground with no visible gap between the midsole of the feet and the floor.
Flat feet can be classified as structural (i.e., hereditary) or functional, and the causes of it can be multifactorial.
In addition, sub-optimal alignment of the joints in the ankles, knees, hips, and lower back may contribute to an increased risk of injuries during activities.
Flat feet are usually not of concern if no pain or discomfort is experienced, and thus, no treatment is necessary.
However, if flat feet are causing pain and/or discomfort in your daily activities, proper strengthening and stretching exercises can help to correct the issue as well as alleviate symptom(s).
What are flat feet?
I’m sure you’ve heard of flat-footedness more than just a few times in your life. So, what exactly is it, and do you actually have flat feet? More importantly, if you do, what should you expect out of it, and what else can you do about it? Now, let’s find out more!
With the majority of people, there is a gap beneath the underside of the foot and the ground when you stand, causing an “arch” to be formed. Flat feet are characterized by a lack of an arch like this, or a very low arch, i.e., with the arch almost touching the ground.
How do you check if you have flat feet?
Image of normal vs flat feet via https://www.researchgate.net/figure/Difference-between-normal-and-flat-feet_fig2_336690203
Stand still in front of a mirror and take a look at the inner side of your foot. In normal feet, there would be a slight lift or arch in the inner sole. If you are flat-footed, your feet will be fully – or almost fully – touching the ground. If you have difficulty looking, you may get someone else to help check.
Do you also know that flat feet can be further categorized into structural and functional flat feet?
For people with structural flat feet, the lack of arch in the foot is due to the position or the shape of the bones. These arches of the feet may not be present even when the person is in a non-weight-bearing position. Meanwhile, people with functional flat feet actually do have arches on their feet. However, the arches collapse when their feet bear weight, i.e., standing, walking, or running.
What are the causes of flat feet?
There are no definite causes of flat feet, it can be hereditary, where bony alignment differences or ligamentous laxity (hypermobile joints) run in the family.
However, we can also develop functional flat feet from recurrent injuries. For example, recurrent ankle sprains which can cause chronic ankle instability. Gradually, these can lead to overstretching of the soft tissues underneath the foot, laxity in the plantar fascia, and weakness of the muscles that provide stability to the foot arches.
Obesity can be another reason. Being overweight or obese increases the strain on your arches, as your weight is borne by the foot and ankle. Over time, the arches may collapse, which can elevate the risk of developing flat feet to a point where one may experience significant pain whilst simply standing and/or walking. Thus, having a healthy body weight can reduce the load on your feet.
Interestingly, young children are typically flat-footed and their feet only start to form arches at around 6 years old. This is because as the child gets older, their muscles, bones, and tendons grow and develop further.
People with flat feet have a higher risk of injuries. Why?
In normal gait, the mid-foot rolls inwards a little to absorb the impact of load bearing. This movement is called pronation. Conversely, for people with flat feet, the midfoot needs to pronate more than usual in order to absorb the impact of weight bearing. This results in increased stress on the muscles, tendons, and ligaments of the foot and ankle.
As the load on the soft tissues around the ankle and foot increase, over-pronation eventually leads to internal rotation of the lower leg. This can put the knee, hip, and lower back out of alignment, potentially resulting in further injuries.
Do I need to do anything if I have flat feet? Will I feel pain?
The good news is: not everyone with flat feet will experience pain. If the ankle and foot muscles are able to support the arches of the feet even when it flattens excessively, there is no need for interventions.
The human body is very versatile – akin to a well-lubricated walking machine. The muscles, tendons, and ligaments in our lower limb function like a spring. For example, when our foot pronates when we place weight on it, the soft tissues underneath the foot are being stretched, storing potential energy. This energy is released when the foot pushes off, which propels the body forward. Thereafter, these soft tissues return to their original position.
If you do not feel pain, this means your body is more than capable of correcting, redirecting, and reinforcing the ankle-and-feet structure to allow for a long-term “smooth transaction”. The bottom line is, if you don’t feel pain, nothing needs to be done.
Usain Bolt, also known as the ‘fastest man alive’, is a world record holder in the 100 meters, 200 meters, and 4 × 100 meters relay.
Usain Bolt’s flat feet
Usain Bolt’s spinal scoliosis
Do you know that Usain Bolt, the fastest man in the world, has flat feet? Not only does Usain Bolt have flat feet, he also has spinal scoliosis. One would expect poor athletic performance due to these structural faults. However, Usain Bolt has proven otherwise.
Take a look at the videos below! These are exercises and stretches that will help to improve the mobility of the ankle joint, flexibility and strength of the muscles supporting the arches of the foot. When performing these exercises, it is important to maintain overall stability, good hip, knee, and ankle alignment.
1. Heel raises
Find a step nearby something you can hold on to (e.g., a handrail or a wall). Stand at the edge of a step and take a deep breath while slowly raising both heels. Keep both legs as straight as you comfortably could. Then, slowly lower both heels until you feel a slight stretch in your calf muscles. Try to keep your weight centered instead of rolling towards one side. Perform this 10 times.
2. Stationary lunges
The goal is to maintain good ankle, knee, and hip alignment when executing this exercise.
Stand tall with your chest lifted and feet shoulder-width apart. Step forward with your left foot, keeping the hips squared to the front. Bend the left knee out in-line with the toes by taking a step forward. Your right knee should almost be – but not – touching the floor. Return back to the starting position by driving the body back up through the heel of the front leg. Repeat with your other leg. Alternate between both legs, aiming for 10 times on each side.
3. Calf stretches
Stand an arm’s length away from a wall or a pole (see photo above). Take a step forward with your right leg while placing both hands on the wall for support. Then, extend your left leg backwards, pressing your left heel into the floor. Ensure your hips are squared and toes pointing forward, keeping the back heel on the ground as much as possible. Move your body forward by shifting your right knee slowly towards the wall/pole while maintaining both feet flat on the ground. You should feel a good stretch in your calf muscle on the back (left) leg.
Hold it for at least 30 seconds, and do the same with the other leg. Repeat this three times.
4. Massage plantar fascia and calf muscles
Massaging plantar fascia:
For all of the above exercises, stand upright while holding onto stable support. These self massages will be able to help relieve tensions and ease tightness in the foot or ankle.
For the first exercise, step on the massage ball and slide your foot up and down slowly, maintaining gentle pressure.
For the second exercise, step on the ball with your heel on the ground. Pivot your ankle from side to side, keeping the ball firmly pressed as you swivel back and forth.
For the third exercise, place the ball underneath your heel, and apply gentle pressure while rolling the ball around.
Massaging calf muscles:
This exercise releases tight connective tissue and tight muscles in the lower leg.
Sit down on the floor with the massage ball positioned under your calf. Place your arms behind you as support and lift your buttocks off the ground, putting the majority of your weight on your calf and the other foot. Then, roll the massage ball up and down your calf for a minute or two. Repeat for the other calf.
Having flat feet should not be a worry for anyone – it is a very common condition. As mentioned earlier, if you have no symptoms developed (i.e., pains and aches), then you do not require treatment. However, when problems do arise, we are always here, available and ready to help. You will never be alone on this journey!
If you are interested to learn more about your foot and ankle, check out this post! We’ve covered 9 fun facts that you might not have known.
Facing pain and/or stiffness in your feet? Our qualified physiotherapists can assess the cause of the pain, and advise you on the next step to take. Contact The Movement Laboratory at +65 9755 3516 to make an appointment or for any enquiries!
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