3.21.2014

exercises for flat feet (part 1)

Is it possible to exercise your way out of fallen arches or flat feet? Well, yes and no. We'll try to keep this simple.

The first thing to appreciate is the various types of flat feet, which can basically be divided into issues primarily with the rearfoot, the midfoot, or the forefoot. Whether or not you have a structural foot issue it's more important to know whether or not it's creating a functional issues (problem in the timing and/or extent of joint movement). And that's something Dr. Scholls WalMart Foot Computer can't tell you.

What happens when you move? For example, many people have a mild to moderate flat foot but function very well when they walk, run, and jump. When they move the arch lifts to some extent. Their muscles adequately stabilize the joints in fairly good alignment and lock the associated bones together into a rigid lever. 

On the other hand, someone with a more severe structural issue will likely need a specific type of shoe and/or shoe insert to function at a high level. For these folks, stretching and strengthening exercise may still be of some benefit. Don't get me wrong, all the exercise in the world is not going to fix the low arch. But they may improve the strength and stability enough to get the person to function below injury threshold.

The people who benefit most from doing "arch" exercises are those with a mild to moderate structural or functional low arch. These are the people who function fairly well until they really over-do it with new exercise, or they have become weak, over weight, or use poor quality footwear.

What "low arch" exercises look like will be saved for part two. Many of them can be found with a quick on-line search. Examples include using your toes to bunch a towel up under your foot, picking up small objects with your toes, and pressing your big toe down into the ground as you raise the four lesser toes up. These kind of activities will make the muscles in the arch work to some extent. 

But I think that they're overrated and usually only prescribe them for those who are very weak and/or have a highly sensitive/painful condition in their feet. Examples of higher level and plain better exercises include theraband work, standing and seated calf raises within a controlled range of motion, and something we call "nose leans." [Again, more to come on these.]

Lastly, for many people, the best exercises for the arch are activities that work the entire lower extremity in good alignment. Arch issues tend to be much less of a problem if your hips are strong. Because if you're strong and efficient proximally, your femur won't buckle inward when you step and run and jump, which leads to less inward rotation of the lower leg bones, which leads to less collapse of the bones of the ankle and rearfoot. 

Image: Yes, a low arch causes the leg to roll inward, but likewise, the leg rolling inward does contribute to a low arch!
This idea of giving attention to the alignment, strength, and stability of the entire lower extremity seems to work particularly well with younger populations. But it's never too late to try. Given the fact that you should regularly practice some strength and balance training anyway, why not do something proactive for that flat foot?

Coming in part 2: Suggested exercises for the foot / ankle and general lower extremity, and at least one example of it working to "fix" a low arch.