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.

By Guest Contributor Dr. Scott Gray, PT, DPT

Dr. Scott Gray, PT, DPT, Back In Motion Sport & Spine Physical Therapy

Are you suffering from stiff ankles, repetitive knee pain, plantar fasciitis or other hip or lower back pain?

Hi, I’m Dr. Scott Gray. I’m the owner & founder of Back In Motion in Fort Myers, a doctor of physical therapy, published author, and inventor of the Gray Method™.

In this article, we’re going to describe how your ankle joint can actually be causing your pain and we’re going to show you three ways that you can improve what they call ankle dorsiflexion.

What Is Ankle Dorisflexion?

Ankle Dorsiflexion occurs when you draw your toes back toward your shins. You contract the shin bones and flex the ankle joint. Meaning the flexion of the foot in the dorsal, or upward, direction.

Improving your ankle dorsiflexion can help you achieve more mobility to help take pressure off your knees, plantar fascia, achilles tendon, lower back, etc.

Manually Mobilize The Ankle

The first way we can help improve ankle dorsiflexion is by mobilizing the ankle joint. This is a very important motion for function, whether you like to walk, play sports, run, you name it. This ankle needs to move.

Sometimes it can be the joint that isn’t moving and when the ankle doesn’t get moved optimally at the joint level, then it’s going to limit the range. Whether it be a muscle or not, we have to first get the joint moving.

So, this is a quick, easy treatment we do in our clinic to mobilize that joint. First we need to find what is called the subtalar joint neutral. Start to wiggle that forefoot, until finding the equal distance of the talus.

From here we stabilize that joint and block the tibia and fibula stabilized. Continue working and feeling for the glide of the talus posteriorly to improve that ankle dorsiflexion.

Now, we can mobilize it by continuing to glide it back and forth, and then we can even do a quick thrust down to the ankle joint as well to improve the ankle dorsiflexion mobility.

Hip Flexor Stretch

The second way we can improve ankle dorsiflexion, which isn’t really known by a lot of people is actually attacking the hip joint.

So when we walk in gait, as I step through in a terminal stance, I need maximum hip extension with ankle dorsiflexion.

If I don’t have good hip mobility, I’m never going to improve my ankle dorsiflexion.

Find a chair or step and then from here you’re going to drive our patient’s pelvis forward. What we’re doing is mobilizing the hip into extension, but we’re also getting good, adequate ankle dorsiflexion in that terminal stance.

A lot of times your patients may even have a calf stretch, which is also indirectly going to mobilize that ankle because they haven’t really been in this position in quite some time.

We typically like to spend maybe 20 to 30 reps just mobilizing it then retesting. That’s a just a quick, down, and dirty easy way to get ankle dorsiflexion through the hip.

Downward Dog Calf Stretch

The last way we can improve ankle dorsiflexion is working on the myofascial around it.

The calf is made up of multiple layers and these muscles that can become tight.

Earlier, we talked about how the hip can affect it and the ankle joint itself. This is a quick and easy way to stretch out the calf and so we like to do the yoga downward dog.

So we have our patient get into position by planting both hands flat on the ground in front of them, sending the tailbone up toward the ceiling. Feet should be hip-distance apart. Then just drive the heels down.

This is a quick and easy way you can just have your clients or patients rock their hips back, and that’s going to start stretching out the myofascial. You can hold it for a long duration stretch or you can do it dynamically if they’re getting ready to go for a run or work out.

Conclusion

There you have it, that’s three simple ways you can help your patients improve ankle dorsiflexion.

To recap, we discussed how you can manually mobilize the joint itself, mobilize the hip, and finally stretch the calf.

Incorporating these tips above could help with everything from knee pain, back pain, the achilles tendon, plantar fasciitis, ankle sprains, 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. For more information on how to ease or overcome your injury or pain, go to physical therapy in Fort Myers, Florida , physical therapy in Cape Coral, Florida.

3 Exercises That May Reduce Pes Planus

Are your Patients suffering from flat feet?

What is Pes Planus?

Strengthen the Tibialis Posterior Muscle & Tendon With a Calf Raise

Improve Your Hip Extension

Hip Strengthening

Conclusion

3 Ways to Improving Ankle Dorsiflexion