FLAT FOOT

Saba
5 min readMay 5, 2024

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REHABILITATION.

FLAT FOOT /PES PLANUS is loss of medial longitudinal arch of foot.

The medial longitudinal arch (MLA) plays an important role in shock absorbance and energy transfer during walking.

Biomechanically Flat-arched feet, causes altered foot function, i.e. prolonged calcaneal eversion, increased tibial internal rotation, increased forefoot abduction, reduced efficiency of gait, and reduced shock absorption.

People with flat feet show altered movement biomechanics than normal people, for example, when walking; these people have more pronation in the back of their feet, more plantar flexion in the ankle joint, and more flexion in the knee joint.

In flat foot ,entire lower limb biomechanical alterations happen which causes knee joint valgum ,leading to knock knees and tight hip adductor muscles and weakened hip abductor muscles.

This causes musculoskeletal problems like Achilles tendinitis, iliotibial band syndrome, knee pain, and low back pain . Previous research has shown that 77% of adults with flatfoot have back or lower extremity pain.

A person with moderate or severe pes planus typically is unable to dissipate loads throughout the foot, Hence intrinsic and extrinsic short foot muscles have to work more to compensate for the lack of tension produced in overstretched or weakened foot ligaments and fascia.

Increased muscular activity is needed even during quiet standing, which causes fatigue and various overuse symptoms, including : —

Pain, “shin splints,” bone spurs, and a thickened and inflamed plantar fascia(plantar fascitis).

The good news is that , A variety of therapeutic and clinical interventions is available to treat flat feet, such as the use of orthotics, orthopedic surgery, and the use of special short foot muscle (SFM)exercises.

Rehabilitation of flat foot includes therapeutic exercises of foot _

  1. Short Foot Muscle Exercises (SFM)

EXERCISE 1- RAISE MEDIAL ARCH

RAISE YOUR ARCH OF FOOT HOLD 5 SEC ,10 REPS .3 SETS.

EXERCISE 2: PERONEAL MS STRETCHING.

30 sec hold *3 reps

EXERCISE 3: STANDING SUPINATION

TURN BOTH FEET UP AND INWARDS 10 SEC HOLD*10 REPS-3 SETS

EXERCISE 4: WEIGHT BEARING SUPINATION

raise heels with foot rotated inwards-10 reps,3 sets.

EXERCISE 5: NON WEIGHT BEARING SUPINATION

TOE CURLS +FOOT TAKEN INWARDS HOLD 3 SEC-10 REPS-3 SETS.

EXERCISE 6: TOWEL CURLS

10 SEC HOLD, 10 REPS-3 SETS

EXERCISE 7: THERABAND EXERCISES- 10–15 reps * 3 sets.

A
B
C
D

EXERCISE 7- TIBIALIS POSTERIOR STRENGTHENING:

MOVE THE FOOT IN ADDUCTION AND INVERSION ,THERABAND ANGLED AT 45 DEG FROM FOOT. 10REPS*3 SETS

EXERCISES TO CORRECT KNEE AND HIP JOINT PROBLEMS OCCURING DUE TO FLAT FOOT:

KNEE JOINT:

  1. EXERCISE 1 — VMO STRENGTHENING
HOLD STRAIGHT LEG FOR 10 SEC HOLD*10 REPS -3 SETS.

2. EXERCISE 2 — STRETCHING ILIOTIBIAL BAND.

HOLD 30 SEC * 3 REPS -3 SETS
AFFECTED LEG IS CROSSED BEHIND.

HIP JOINT:

EXERCISE 1- HIP ABDUCTOR STRENGTHENING

10 reps — 3sets

EXERCISE 2: HIP ADDUCTOR STRETCHING

30 SEC HOLD * 3 REPS.

ORTHOSIS USED IN FLAT FOOT:

In a study conducted by Jun Na Zhai et al (2016), it was found that wearing foot insoles in flatfoot persons for upto 3 month significantly reduced plantar pressures by increasing the arch height of foot and distributing the weight from midfoot to forefoot and heel, thus causing less production of fot pain in people with flat feet.

Hence insoles adjust the aligngment of altered bones in flat foot.

In Summary to the recent advances of treatment for flat foot, rehabilitation , in a study conducted by S. Hara et al. / The effects of short foot exercises to treat flat foot deformity: A systematic review, found that —Five weeks of continuous short foot exercises (SFE) for flat feet may improve morphology and proprioception in the Intrincsic Foot Muscles and improve the Medial longitudinal Arch (MLA).

Also SFEs have been shown to be more effective than functional orthotic therapy in improving the MLA.

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Saba
Saba

Written by Saba

Cardiovascular and respiratory Physiotherapist

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