The 4 Causes and Fixes of Flat Feet (Fallen Arches)
Written by Christopher Ioannou, BSc (Hons) Sports & Exercise Science
Reading Time: 9 minutes
Table of contents
The video version of this post:
In this post I’m going to present the four main causes of flat feet, according to the scientific literature. I’ll also provide recommendations on how to overcome each of these issues.
Why Having A Strong Foot Arch Is Important
Figure 1 - Strong foot arches are able to adapt to differing surfaces
A well-functioning foot and foot arch is able to adapt to differing surfaces, behave as a shock absorber and also stiffen up to propel the body forwards during the push-off phase of each step [1].
Figure 2 - The foot arch as the foundational pillar of the body
The muscles, plantar fascia, ligaments and tendons in the feet all form a robust base, in the form of an arch, on which all this can occur. We could, therefore, think of the foot arch as the foundational pillar of the body [2][3][4].
However, an arch that is weak and unable to stiffen properly under the load of one’s bodyweight during movement will just collapse under those forces, making the whole system less efficient, thus hurting performance [5].
Furthermore, because the foot is the most distal part of the body and the only contact point one has with the ground during the gait cycle, even minor changes in the foot arch position have major effects on the balance and posture of the body [1].
In these images below, you can see the effects of having a collapsed arch on the other joints in the body, compared to when one has a healthy arch.
Figure 3 - The effects of having a collapsed arch on the other joints in the body
These changes occur due to the functional relationship between the feet and the other body parts upstream of them. The ability of these parts of the kinetic chain to transmit forces and influence motion between themselves might hold clues to various injuries along this chain [6].
Now, before moving to the crux of this blog post, I first want to help answer a question that I’m sure many of you are asking, namely:
What Are Flat Feet and Do I Have Them?
Scientifically, flat feet are characterised by hind-foot valgus, forefoot abduction and a decrease in the height of the medial longitudinal arch [7].
In more simple and practical terms, looking at our heel from behind, one should see neutral alignment. Any collapsing inwards is a sign of flat feet.
Figure 4 - Any collapsing inwards is a sign of flat feet
From the top view, we should see neutral alignment running from the midfoot through the big toe. Any misalignment could be a strong indicator of fallen arches.
Figure 5 - Any misalignment could be a strong indicator of fallen arches
Finally, from the side, strong arches will present themselves with a prominent dome-shaped foot curve. If there is little indication of such a shape, then one has a collapsed or flattened arch.
Figure 6 - If there is no indication of a dome-shaped foot arch, then one has a collapsed or flattened arch
Identifying one or more of these three indicators in the foot would suggest that the arch is weak and inactive.
The Prevalence of Flat Feet
Figure 7 - Flat feet have been found to be five times more common than high arches
If you do happen to have fallen arches, you're not alone.
Flat feet have been found to be five times more common than high arches. It is the most prevalent foot problem in the US. Overall, it is estimated that roughly 40% of Americans suffer from foot problems [7][8].
These statistics are alarming, especially since having nice, strong arches is essential for optimal athletic performance and injury prevention.
The 4 Causes and Fixes of Flat Feet (Fallen Arches)
Fortunately, through our extensive research and experience, my team and I have identified four of the most significant reasons for which people develop flat feet, and how these issues can be rectified.
Let's run through them.
Wearing the wrong shoes
Figure 8 - Shoes have changed a lot throughout the years
Shoes have changed a lot over the years. They started off as pure utility wear, meant to keep the feet warm in extreme cold and protect them from harsh terrain. Nowadays, footwear is part of a trillion-dollar fashion industry, in which the emphasis is placed on the aesthetics more than utility.
Unfortunately, this shift in the way we utilise and design our footwear has had some repercussions for the health of our feet.
For example, a study done on the native Mexican Tarahumara tribe, who mostly wear barefoot sandals, found that they were 25 times less likely to have flat feet than urban Americans, who predominantly wear conventional footwear [9].
Another study, this time on 2,300 children, found that children who were predominantly barefoot were three times less likely to have flat feet than children who wore shoes [10]. This study also showed that wearing shoes before the age of six was detrimental to the development of children's feet and arches.
You can learn more about why traditional footwear is bad for the feet through some of our previous posts:
HOW TO SAFELY TRANSITION TO BAREFOOT RUNNING SHOES WITHOUT GETTING INJURED
BAREFOOT RUNNING TECHNIQUE SIMPLIFIED | WHY IT IS SO EFFICIENT
PREVENT RUNNING INJURIES BY BAREFOOT RUNNING & FOREFOOT STRIKING
So, to overcome this issue, one can spend as much time barefoot as possible.
Personally, I don't wear shoes around the house. The rest of the time I wear barefoot shoes, which are designed to mimic being barefoot while still protecting one’s feet from harsh conditions.
Here are our most popular barefoot shoe reviews:
Weak Intrinsic Foot Muscles
Figure 9 - The Foot Has Intrinsic and Extrinsic Muscles
Each foot is controlled by 13 extrinsic and 21 intrinsic muscles [11].
If these muscles are weak or unresponsive, then the integrity of the foot arch is lost.
Figure 10 - Inflammation in the Plantar Fascia
Large deformations or the arches collapsing in every step puts a huge strain on the passive tissues, such as the plantar fascia, which is why plantar fasciitis has been associated with this issue [2][3].
To show just how important the muscle in the feet are for maintaining a foot arch, a study was conducted in which the researchers paralysed the foot muscles via anaesthesia. The results showed a 50% average reduction in arch height among their participants [6].
Therefore, strengthening the foot muscle must become a priority when trying reverse flat feet.
Figure 11 - Abductor Hallucis, Abductor Digitis Minima and Tibialis Posterior Muscles
Of all these muscles in and around the foot – the abductor hallucis, abductor digits minimi and the tibialis posterior – have been found to play a key role in stabilising the arch [5][9][12].
These are some of the specific muscles we target in our “Strong feet, Strong Foundation Program”.
Studies utilising foot-strengthening programs, such as ours, have been found to significantly improve foot function and reduce the presence of flat feet [13].
Figure 12 - Studies utilising foot-strengthening programs
Tight Calves and Restricted Ankles
Figure 13 - Our foot arch is capable of functioning as a spring
To be clear, a well-functioning foot arch is dynamic. It is capable of flattening upon impact, after which it stiffens during the propulsion and toe-off phase of the gait cycle. In this way, our foot arch is capable of functioning as a spring, which has been found to conserve 17% of our energy while running [14][15].
Now, as I've mentioned earlier, the foot muscles help to stabilise and form the arch.
Figure 14 - The Calves and Achilles Tendons contract to exert opposing forces
On the other hand, the calves, together with the Achilles tendon, contract to exert opposing forces on the feet in order to precipitate their spring-like effect.
However, for this system to work efficiently, the foot arch strength must match that of the calves and ankle musculature. Otherwise, the calves will overpower the foot, resulting in excessive flattening of the arch [5].
So, while foot-strengthening exercises can be very helpful in trying to improve the balance between these opposing forces, we also need to ensure that the calves and ankles are not overly tight either.
Figure 15 - Raised heels force the feet into a slightly plantar-flexed position
One of the major issues with traditional shoes is the raised heels, which forces the feet into a slightly plantar-flexed position, whereby the calves have to remain in a constant shortened state. Over time, this produces chronically tight calves and tight ankles, which then puts too much strain on the feet and makes it difficult to hold an arch.
Now, there are two ways to go about improving ankle mobility and reducing tightness in the calves.
Figure 16 - Barefoot style shoes don't have a raised heel
The first step is to avoid wearing shoes with a raised heel. Zero drop barefoot style shoes, for example, keep the feet in a level position at all times, which can really help to rectify tightness in the ankles.
The second step is to work with various ankle mobility drills and stretches to restore the full range of motion in these joints. We also include these drills in our “Strong Feet, Strong Foundation Program”.
Weak Glutes (External Rotators)
As explained earlier, the body is an integrated system. So, dysfunction in one area has consequences for other areas along the kinetic chain [3].
Figure 17 - When the glutes don't function properly it shows on the body upstream and downstream
The gluteal muscles are no different. Because they are external rotators of the upper limbs, when the glutes don't function properly, the thigh bone rotates internally, which causes the knee to dive inwards, which then sends the foot into over-pronation and collapses the arch [16].
As you can see, what seems to be two unrelated parts of the body in isolation are, in fact, both part of a tightly-integrated kinetic chain and drastically affect one another.
It is for this reason that studies have found that gluteal-strengthening exercises in combination with foot-strengthening exercises is far better at correcting a shallow medial longitudinal arch than foot-strengthening exercises alone [16].
Therefore, it is absolutely critical to include glute strengthening exercise in your regime, when you're trying to fix flat feet.
Conclusion
In conclusion, having flat feet is a very common issue, which not only affects one’s athletic performance, but can also increase one’s risk of developing injuries. After all, it's the only contact we have with the ground in the majority of our athletic activities.
However, by addressing the four areas we presented in this video, one can significantly improve the strength of one’s foot arches. For those who are serious about building strong feet, don't forget to check out our “Strong Feet, Strong Foundation Program”.
Bear in mind that, because the research surrounding this topic is always evolving and our knowledge is expanding, by purchasing this programme you’ll not only receive the current version of the product, but you'll also get the updates we make to the programme in the future.
Well, that's it from us today. Thanks for reading. I’ll see you next time for more health science made simple. Cheers.
