3 Exercises That May Reduce Pes Planus

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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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The E Quad for Practitioners

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By Dr. Louis J. DeCaro, DPM

The E foot type is a common foot type presenting to podiatry offices. The E foot type causes the foot to both pronate from the rearfoot and forefoot. The significant amount of pronation causes torqueing forces on the body from the time of first steps. While the forefoot varus position and hence pronation may not fully present until around the age of 6 or 7 (6/7 is forefoot maturity) it is common for symptoms to present. Symptoms however are not always “pain-based.” The E foot type at an early age (especially in those with developmental delays) present with poor posture and overall gross motor weakness. This can delay natural milestones of running and walking significant distances. As well the core and hips can suffer. At around the age of 4-6 this can then present as “growing pains” in the lower legs. This is very common and commonly left un-treated for the sake of blaming it on “growing pains.” In fact often the forefoot is maturing and with that forefoot varus maturation comes torque force on the LE leading to “growing pains in the legs” which are actually biomechanically caused. We often see Severs 8-12 yo with an E foot type and then many children/teens with shin splints who play running sports from the ages of 11-19. Throughout all the childhood ages however poor endurance, fatigue of running/walking, and slow “out of the blocks” are common chief complaints without the pain. As well irregular running styles with significant leg motion can be seen in children who are involved in running sports. All of these painful and non-painful symptoms should be treated with an orthotic. Later in life in the adult stages this foot type cacn cause frequent knee and or hip pain as well.

For more on the E Quad visit our website:
https://nolaro24.com/quade.html

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Pediatric Toe Walking with Dr. Liesa Ritchie-Persaud PT, DPT, PCS

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More than Child’s Play

Pediatric toe walking is an atypical movement pattern that is poorly understood but can have a wide range of short and long term consequences for children. In this episode, we are thrilled to bring you THE expert in this area of physical therapy practice, Dr. Liesa Ritchie-Persaud. Through her business, Know To Change, Leisa brings years of clinical expertise, global work in continuing education, and her own technique for assessment and treatment of idiopathic toe walking. In this episode, cover why children toe walk, why toe walking should be treated and the risks of not treating it, common diagnoses associated with toe walking, and how vision affects toe walking. Liesa answers common questions about use of saucers and walkers, shoes, botox, casting, and surgery and provides detailed guidelines of when children should be referred and treated for toe walking by a skilled therapist. Finally, she explains the differences in the courses she offers for therapists who want to learn more. Whether you are a parent or a therapist facing this often pesky and persistent diagnoses, this conversation is sure to further your knowledge and understanding and inspire your work.

Listen to Liesa’s Podcast HERE

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