Pes planus, commonly known as flat feet or fallen arches, is a condition where the arch along the inside of the foot collapses, causing the entire sole to make contact with the ground when standing. This configuration is common, affecting a significant portion of the population. While often asymptomatic, it can contribute to pain in the feet, ankles, knees, or back for some individuals. The effectiveness of targeted exercises depends heavily on the specific nature of the flat foot, which is foundational to treatment planning.
Understanding Flexible Versus Rigid Flat Feet
Flat feet are categorized into two primary types based on their structural behavior: flexible and rigid. This distinction determines the potential for improvement through physical training. Flexible flat feet are the most common presentation; an arch is visible when the foot is not bearing weight (such as when sitting or standing on the toes), but it disappears or collapses when the person stands flat on the ground.
Conversely, rigid flat feet display an absence of an arch in all positions, whether standing, sitting, or raising the toes. This lack of movement often indicates a structural or bony issue, such as a congenital abnormality or advanced arthritis, making the condition far less responsive to strengthening exercises alone. Flexible flat feet are generally amenable to functional improvement through exercise, while rigid flat feet often require more comprehensive medical intervention.
How Exercise Supports Foot Function and Arch Stability
Exercise works to improve foot function not by changing the underlying bone structure, but by strengthening the muscular system that supports the arch. The arch is maintained by a combination of passive structures (ligaments and bones) and active, dynamic stabilizers (the muscles). Training these muscles enhances the foot’s ability to absorb shock and maintain proper alignment during movement.
The primary dynamic support for the medial longitudinal arch comes from the posterior tibialis muscle, which originates in the lower leg and attaches to bones in the midfoot. This muscle acts as a strong inverter of the foot and helps to lift the arch dynamically during standing and walking. Intrinsic foot muscles, such as the abductor hallucis located along the inner sole, also play a significant role in providing localized stability and contributing to the arch’s ability to dome.
By strengthening these supporting muscle groups, individuals with flexible flat feet can improve their gait mechanics and reduce the excessive inward rolling of the foot, known as overpronation. This muscular support acts as a tension-cable system, improving the foot’s resilience and shock absorption capabilities, even if the actual arch height does not increase substantially. Stronger foot and lower leg muscles can mitigate associated symptoms like foot fatigue, ankle pain, or knee discomfort arising from poor alignment.
Specific Exercises to Strengthen the Arch and Supporting Muscles
Targeted exercises aim to activate and strengthen the intrinsic and extrinsic muscles responsible for dynamic arch support. One effective practice is the Short Foot Exercise, sometimes called Foot Doming, which focuses on contracting the small muscles within the sole of the foot without curling the toes. To perform this, place the foot flat on the floor and attempt to shorten the distance between the heel and the ball of the foot, causing the arch to lift. This action should be held for several seconds and repeated multiple times, focusing on the quality of the contraction rather than the magnitude of the arch lift.
Another exercise involves using a small towel placed under the foot. The individual uses their toes to repeatedly scrunch and pull the towel toward the heel, which isolates and strengthens the toe flexors and intrinsic foot muscles. A modified calf raise can also target the extrinsic muscle group, particularly the posterior tibialis.
This modification involves performing the calf raise while emphasizing the eccentric phase—the controlled lowering back down to the starting position. To perform this, rise onto the balls of the feet and then slowly lower over a count of three to five seconds, ensuring the heel tracks straight without collapsing inward. Consistency and proper form, such as performing these exercises three to five times per week, are more beneficial than high volume.
When Medical Intervention Is Necessary
While exercise is beneficial for flexible flat feet, it is not a complete solution for everyone, particularly those with rigid or painful flat feet. If a person experiences persistent pain in the feet, ankles, or lower legs—especially pain that limits daily activities or does not improve after weeks of conservative exercise—a healthcare professional should be consulted. Rapid or sudden arch collapse in adulthood also warrants immediate medical attention, as it may indicate a serious issue like posterior tibial tendon dysfunction.
A physical therapist can provide a detailed gait analysis and customize a strengthening program that addresses specific muscular imbalances. Non-exercise interventions often include custom orthotics, which are specialized shoe inserts that provide passive support to the arch. These devices help to realign the foot and ankle, reducing strain on soft tissues and providing immediate relief that exercise alone may take longer to achieve. In rare and severe cases where chronic pain is debilitating or structural abnormalities are present, surgical correction may be considered as a last resort when all conservative treatments have failed.