Flat feet describe a condition where the arch along the inside of the foot collapses, causing the entire sole to touch or nearly touch the ground when standing. This loss of the medial longitudinal arch compromises the foot’s natural spring mechanism, which is designed to absorb shock and distribute weight. This structural change often leads to pain and poor alignment, raising questions about the possibility of correction.
Differentiating Flat Feet
Understanding the nature of the flat foot is fundamental because it dictates the potential for correction and the most effective treatment path. The condition is broadly classified into two distinct types: flexible and rigid flat feet.
The flexible type is significantly more common and is characterized by a visible arch when the foot is not bearing weight, such as when sitting or standing on tiptoes. This arch, however, flattens completely once the person stands and puts weight on the foot. Flexible flat feet often result from ligamentous laxity or weakness in the tendons, such as the posterior tibial tendon, that are responsible for dynamic arch support.
In contrast, rigid flat feet are a more severe and less frequent condition where the arch remains collapsed regardless of whether the person is standing or at rest. This type is typically linked to a fixed structural abnormality, often present from birth, such as tarsal coalition, which is the fusion of two or more bones in the hindfoot. The distinction is crucial; flexible flat feet respond well to non-surgical interventions, while the rigid form may necessitate more complex treatment due to the fixed bony structure.
The Potential for Arch Improvement
The central question of whether you can “build an arch” must be approached by clarifying the goal: for the flexible type, improvement focuses on function, not a complete structural overhaul of the bone architecture. It is not possible to create new bone to elevate the arch in an adult or child where none existed, but it is highly possible to strengthen the surrounding soft tissues to provide functional support. The foot’s arch is maintained by a complex interplay of bones, ligaments, and a network of muscles and tendons that act like supportive cables.
The true objective is to strengthen the muscular components that stabilize the arch, most notably the deep, intrinsic foot muscles that originate and insert entirely within the foot. By targeting these muscles, it is possible to enhance the foot’s dynamic stability and improve its ability to absorb shock during movement. This strengthening effectively creates a form of muscular arch support that mimics the action of a naturally high arch. While the foot may not achieve a high, textbook arch profile, the enhanced functional support can reduce pain and improve gait mechanics significantly.
Active and Passive Correction Strategies
Correction strategies are often divided into active methods that rely on muscle engagement and passive methods that use external support. Active strategies focus on physical therapy and specific exercises designed to train the intrinsic foot muscles to lift and maintain the arch.
Active Strategies
The most effective of these is the “short foot exercise,” or foot doming, which involves actively pulling the big toe joint toward the heel to shorten the foot and raise the arch without curling the toes. This isometric contraction directly targets the arch-supporting muscles and has been shown in studies to engage them more effectively than traditional toe exercises. Other helpful active methods include toe curls, where a person uses their toes to scrunch a towel or pick up small objects like marbles, which also strengthens the small muscles in the sole of the foot. Incorporating heel raises helps to strengthen the lower leg muscles that contribute to overall foot and ankle stability. Simple activities like mindful barefoot walking on varied, natural surfaces can also help to engage and strengthen the small, stabilizing foot muscles naturally over time.
Passive Strategies
Passive strategies involve the use of external devices to manage symptoms and encourage proper foot alignment. Orthotics, which are specialized shoe inserts, work by redistributing pressure across the sole and discouraging the foot from rolling inward excessively, a common issue known as overpronation. Custom orthotics are molded to the individual foot and can be designed as “active” devices that attempt to hold the foot in a corrected position.
These devices provide immediate relief and stability, especially during high-impact activities like running, by cushioning the foot and reducing strain on the arch. However, orthotics are generally considered a short-term solution for symptom management; they do not strengthen the underlying muscles. Long-term management for flexible flat feet is most successful when passive support from orthotics is combined with active strengthening exercises to develop the foot’s natural stabilizing capacity.