By Dr. Scott Gray
Are your Patients suffering from flat feet?
Hi, I’m Dr. Scott Gray. I’m the owner of Back in Motion in Ft. Myers, Florida, a doctor of physical therapy, published author, and inventor of the Gray Method™.
In this article I’m going to show you three ways that may help reduce pes planus, or flat feet.
What is Pes Planus?
Pes planus also known as flat foot is the loss of the medial longitudinal arch of the foot, heel valgus deformity, and medial talar prominence.
Flat feet may be causing plantar fasciitis, knee pain, back pain, or even hip pain.
Strengthen the Tibialis Posterior Muscle & Tendon With a Calf Raise
One of the best ways to reduce pes planus and mitigate it is to strengthen the posterior tibialis muscle and tendon complex. So as we walk and gait in a terminal stance, that foot should supinate where it’s not flat
What we can do to help develop this is to do a simple calf raise.
By going up on your toes you can see whether or not the heel goes into supination and that’s really what we’re looking for.
That’s going to help pull on the midfoot and even some of the rear foot there as the tendons come through to provide stability into the opposite of flat feet.
So we would typically like to do this in three sets of 10 to 15 reps a couple times a week to help just get some strength and stability of that complex.
Improve Your Hip Extension
The second way to help mitigate flat feet or pes planus is to actually work the hip in getting the hip to extend.So what happens commonly is we walk, if you don’t have hip extension mobility, then the foot can’t resupinate.
The foot will go into pes planus or flat feet. We really want to make sure that we give the ankle joint enough time to dorsiflex. Which then allows that windlass mechanism to kick in, where the foot can start to supinate at the rear foot.
How we do this is having the patient go into a lunge like position, having a stretch cage is helpful, and the patient will drive back and forth and really work on getting motion in the hip.
If you don’t have mobility at the ankle joint, then what happens is the subtalar joint will revert and it causes motion at the midtarsal joint to give false dorsal flexion.
So we really want to make sure we’re getting true, authentic dorsiflexion so that the midtarsal joint doesn’t have to unlock which then will allow the foot to get rigid and become a stiff lever in the gate. So that’s just an easy way to get dorsiflexion.
Hip Strengthening
So the last way we can mitigate pes planus is actually working the strength of the hip.
If I’m standing and I have weak hips, it’s going to potentially make my knees cave in which down the chain is going to make my feet go into pronation as a compensation.
If I work on strengthening some of my butt muscles and deep hip rotators, I can potentially help mitigate those forces of my flat feet.
One exercise that we really like to do here at Back in Motion is a hip airplane, and so we have the patient hold onto something because it’s not a balance exercise.
Then from here, they are going to rotate their hip into what we call external rotation and extension. And that’s going to get these deep hip rotator muscles working, which is going to help prevent ultimately from being in this knock-knee position, which can make her feet flat.
Conclusion
So there you have it. Those are three simple ways to mitigate pes planus or flat feet. We talked about the calf raise to work the posterior tibial tendon, and working the hip indirectly by mobilizing into extension, so that the midtarsal joint doesn’t have to unlock.
And lastly we talked about strengthening the glutes to help prevent some of that femoral internal rotation so that doesn’t happen at the feet.
Incorporating these tips above could help with everything from knee pain, back pain, hip pain, plantar fasciitis, and so much more.
About The Author: Dr. Scott Gray
Dr. Scott Gray is an internationally recognized and expert physical therapist & sports performance coach specializing in sport, athletic, and back and neck injuries. He is the inventor of a revolutionary form of treatment called the GRAY METHOD™. This type of treatment unlike others, addresses the CAUSE rather than just your SYMPTOMS with a full body approach. Learn more about what Back In Motion in Ft. Myers, FL has to offer other than physical therapy including sports performance training, personal training.
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