Understanding Flat Feet: Causes, Science, and How Exercises Can Help

Flat feet also known as "pes planus" affect millions of people of all ages. For some, it's a minor cosmetic issue. For others, it can lead to pain, postural problems, and long-term complications. Why does this happen? And can you do something about it?

What Are Flat Feet?

Flat feet occur when the arches on the inside of the feet are flattened, so the entire sole touches the floor when standing. This is often due to problems in the bones, muscles, ligaments, or tendons that support the arch.

Normal Arch Development

• Babies are usually born with flat feet.

• Arches typically develop by age 5 to 7 as foot muscles and ligaments strengthen.

• In some people, the arch never fully forms or collapses later in life.

Common Causes of Flat Feet

1. Ligament Laxity

• Loose or stretchy ligaments allow the bones to collapse downward.

• Common in children or people with joint hypermobility.

2. Muscle Weakness (Especially Posterior Tibialis)

• Muscles like the Posterior Tibialis supports the arch. Weakness or tendon injury can lead to adult-acquired flatfoot, especially in women over 40.

3. Structural or Bone Abnormalities

• Some are born with abnormal joint or bone structures, such as tarsal coalition (fused bones).

• Often leads to rigid flatfoot, which is more likely to be painful.

4. Obesity or Overuse

• Carrying excess weight or repetitive high-impact activity can strain and flatten the foot structures over time.

5. Injury or Trauma

• Damage to the foot or ankle—especially to the posterior tibial tendon—can cause the arch to collapse.

6. Neurological Conditions

• Disorders like cerebral palsy or muscular dystrophy can alter muscle tone and balance, impacting arch formation.

Types of Flat Feet

Type	Description
Flexible Flat Feet	Arch appears when not bearing weight, flattens when standing. Most common and usually less severe.
Rigid Flat Feet	Arch is always absent, even when the foot is off the ground. Often caused by bone or joint issues.
Adult-Acquired Flatfoot	Occurs when the arch collapses over time, often due to tendon dysfunction.

Why It Matters: The Biomechanical Effects

Flat feet can cause the foot to overpronate (roll inward), affecting body alignment. This can lead to:

• Foot and ankle pain

• Knee or hip misalignment

• Lower back discomfort

• Increased risk of plantar fasciitis and shin splints

Can Exercises Help Flat Feet?

Short Answer: Yes but with some limitations.

Orthopedists and physical therapists often recommend targeted foot exercises to:

• Strengthen muscles that support the arch (https://youtu.be/8FNqURO9VlI?si=7m0XtKkBqNtX9ZFC)

• Improve balance and posture

• Reduce pain and prevent further flattening

Benefits of Flat Feet Exercises

1. Arch Strengthening

Exercises like short foot raises and towel scrunches activate small muscles that lift and support the arch.

2. Pain Relief

A stronger, better-aligned foot often results in reduced strain on the plantar fascia, ankles, knees, and lower back.

3. Improved Walking & Balance

Better muscle coordination can correct overpronation and improve gait.

4. Injury Prevention

Strengthening the foot reduces stress on the tendons and ligaments, helping to avoid overuse injuries like shin splints or tendonitis.

5. Non-Invasive, Cost-Effective

These exercises are simple, low-risk, and can be done at home without expensive equipment.

Limitations of Flat Feet Exercises

1. Not a Cure for Everyone

In rigid or structurally abnormal flat feet, exercises may offer little to no improvement without additional interventions.

2. Slow Progress

It can take several weeks or months of consistent effort to see noticeable changes.

3. May Need Additional Support

Exercises often work best when paired with orthotics or supportive shoes, especially in moderate to severe cases.

4. Won’t "Rebuild" Arches in Adults

For most adults, the goal is to improve function and reduce symptoms not to “fix” the arch shape.

Common Orthopedic Exercises for Flat Feet

1. Towel Scrunches – Strengthen arch muscles

2. Short Foot Exercise – Activate intrinsic foot muscles

3. Heel Raises – Strengthen calves and posterior tibialis

4. Calf Stretch – Relieve tightness that pulls on the arch

5. Tennis Ball Roll – Loosen plantar fascia

6. Toe Curls with Resistance Bands – Build toe and arch control

7. Toe Walking / Heel Walking – Improve balance and strength

Flat feet have a variety of causes some structural, others muscular or neurological. One thing is certain strengthening your feet will always help and including barefoot walking in your daily life can make a difference.

While not all cases can be fully "fixed," therapeutic exercises are a powerful tool in managing the condition. They help strengthen the foot, reduce symptoms, and improve quality of life.

However, they’re not a one-size-fits-all solution. If you're not seeing results or experiencing pain, consult an orthopedic specialist or physical therapist. With the right approach, many people with flat feet can walk, run, and live pain-free.