In this article, I’m going to scientifically explain the four main causes of flat feet. I will also give you recommendations on how to overcome each of these problems.

The feet are arches that in normal function are able to adapt to different surfaces, act as a shock absorber and stiffen to propel the body forward. During the pushing phase of each step, the muscles, plantar fascia, ligaments and tendons of the feet all form a strong base in the form of an arch called the arch. The arch of the foot can therefore be considered a fundamental pillar of the body. However, a weak arch is unable to stiffen properly under the weight of the body during movement and will collapse under these forces, making the entire system less efficient and thus hindering performance. Therefore, since the foot is the most distal part of the body and the only point of contact with the ground during the gait cycle, even minor changes in the condition and position of the arch of the foot can have major consequences on body balance and posture.

These changes occur because of the functional relationship between the feet and other upstream body parts. The ability of these parts to transmit forces and influence movements between them could be the source of various injuries along this chain.

Before I get to the main point of this article, I would like to first answer a question that I am sure many of you are asking. Namely, what is flat feet and do I have them scientifically?

Flat feet are characterized by an abduction of the foot, forefoot and a decrease in the height of the medial longitudinal arch. In simpler and more practical terms, looking at your heel from behind, one should see a neutral alignment. Any inward collapse is a sign of a flat foot when viewed from above. You should see neutral alignment from the midfoot to the big toe. Any misalignment can be a strong indicator of arch drop. Finally, from the side, strong arches will present with a prominent dome-shaped plantar groove. If there is little evidence of such a shape, it is a collapsed or flattened arch. The identification of one or more of these three indicators in the foot suggests that the arch is weak and inactive.

If you happen to have a collapsed arch, know that you are not alone. Flat feet have been found to be five times more common than normal arches. It is the most common foot problem in the world. Globally, it is estimated that approximately 30% of people suffer from foot problems.

These statistics are alarming, especially since strong, beautiful arches are essential for optimal athletic performance and injury prevention. Fortunately, through our extensive research and experience, my team and I have identified four of the most important reasons why people develop flat feet and how these problems can be corrected. Let’s review these reasons.

The first is wearing the wrong shoes. Shoes have changed a lot over the years. Originally, they were purely utilitarian, intended to keep feet warm and protect them from rough terrain. Today, shoes are part of a billion dollar fashion industry in which the focus is on aesthetics over utility. Unfortunately, this change in the way we use and design our shoes has had an impact on the health of our feet. For example, a study of the indigenous Mexican Tarahumara tribe, who primarily wear barefoot sandals, found that they were 23 times less likely to have flat feet than urban Americans who primarily wear conventional shoes. Another study, this time of 2,300 children, found that children who were primarily barefoot were three times less likely to have flat feet than children who wore shoes. The study also showed that wearing shoes before the age of six was detrimental to the development of children’s feet and arches.

So, to overcome this problem, one can spend as much time as possible barefoot. Personally, I don’t wear shoes at home; the rest of the time, I prefer shoes that are designed to mimic going barefoot while protecting the feet from harsh conditions.

The second cause of flat feet is weakness of the intrinsic muscles of the foot. Each foot is controlled by 13 extrinsic muscles and 21 intrinsic muscles. If these muscles are weak or unresponsive, the integrity of the arch is lost, usually resulting in arch collapse. Large deformations or collapse of the arch with each step puts tremendous pressure on passive tissues, such as the plantar fascia. The plantar fascia is a thick fibrous band of connective tissue that extends from the heel to the base of the toes and supports the arch of the foot. A study was conducted in which researchers paralyzed the foot muscles with anesthesia. The results showed an average 50% reduction in arch height in their participants. Therefore, strengthening the foot muscles should become a priority. When trying to reverse flat feet all of these muscles in and around the foot have been found to play a key role in stabilizing the arch, the abductor, abductor helicis, digital M.E. and posterior tibial.

The third factor in flat feet is calf tension and ankle restriction. A well functioning arch is dynamic. It is able to flatten on impact and stiffen during the propulsion phase as well as the total phase of the gait cycle. In this way, our arch is able to function like a spring, conserving 17% of our energy during running. As I mentioned earlier, the foot muscles help stabilize and shape the arch of the foot. On the other hand, the calves and Achilles tendon contract to exert opposing forces on the feet to precipitate their spring effect. However, for the system to work effectively, the strength of the arch must match the strength of the calves and ankle muscles. Otherwise, the calves will overpower the foot, resulting in excessive flattening of the arch.

Foot strengthening exercises can be very helpful in trying to improve the balance between opposing forces. We also need to make sure that the calves and ankles aren’t too tight either. One of the main problems with some of our shoes is the height of their heels, which forces the feet into a fixed, slightly planted position, forcing the calves to remain in a constant state of shortening. Over time, this produces chronically tight calves and tight ankles. This puts too much pressure on the feet and makes it difficult to maintain the arch of the foot. There are two ways to improve ankle mobility and reduce calf tension. The first step is to avoid wearing shoes with a raised heel. For example, barefoot type shoes with no drop. Keep your feet in a horizontal position at all times, this can really help reduce tension in the ankles. The second step is to work with various ankle mobility and narrowing exercises to restore full range of motion to these joints.

The fourth and final factor we will look at is gluteal or external rotator weakness. As explained earlier, the body is an integrated system. Thus, dysfunction in one area impacts other areas of the kinetic chain. The gluteal muscles are no different because they are external rotators of the upper limbs. When the glutes are not functioning properly, the femur rotates internally, which causes the knee to dip inward and then leads to excessive pronation of the foot and collapse of the arch. As you can see, what appears to be two unrelated and isolated body parts are actually part of a tightly integrated kinetic chain and significantly affect each other.

Studies have shown that gluteal strengthening exercises combined with foot strengthening exercises are much better at correcting a shallow medial longitudinal arch than foot strengthening exercises alone. Therefore, it is absolutely essential to include gluteal strengthening exercises in your program when trying to correct your flat feet problems.

In conclusion, flat feet are a very common problem that not only affects sports performance, but can also increase the risk of injury. However, despite the four main factors presented in this article, know that it is possible to significantly improve arch strength for those who want to have strong feet.

That’s it for this article. If you liked it, please leave me a comment and don’t forget to subscribe to the newsletter so you don’t miss any more publications.

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