Mend Physical Therapy Blog and Injury Information

Have Flat Feet? Exercise vs. Orthotics

April 18, 2022

Pes planus, otherwise known as flatfoot, is a common condition experienced by many individuals that is often associated with plantar fasciitis and development of knee and hip pain. Foot orthotics are commonly prescribed as a first line intervention for individuals with pes planus, but the research shows that short foot exercises should be included as a primary treatment strategy for pes planus.

Protopapas et al published a randomized controlled trial in August 2020 that sought to determine the effect of a 12-week custom orthotic intervention on intrinsic foot muscle size and activity. The authors measured a significant decrease in muscle size of the flexor digitorum brevis, abductor digiti minimi, and abductor hallucis without noting a change in muscle activity. They suggest that a course of short foot exercises should be included with any custom orthotic intervention to reduce the risk of disuse atrophy of the intrinsic foot musculature.

Another study published in September 2019 by Okamura et al showed that an 8 week course of short foot exercises performed 3 times per week was able to effectively correct static foot alignment in individuals with pes planus and significantly improve foot kinematics during walking tasks. Unver et al published similar findings in October 2019 showing that a 6 week course of short foot exercises performed daily had a significant impact on pain, disability, and foot pronation.

Try this exercise progression to strengthen the intrinsic muscles of your feet:

The highly skilled physical therapists at MEND serving Boulder, Lafayette, Louisville, Erie, and Superior can perform a comprehensive evaluation of your foot and ankle condition as well identify any imbalance or deficit in the entire kinetic chain that can be contributing to your condition. Schedule an evaluation today if you would like to have one of our experts provide the best course of intervention for your specific needs.

Protopapas K, Perry SD. The effect of a 12-week custom foot orthotic intervention on muscle size and muscle activity of the intrinsic foot muscle of young adults during gait termination. Clin Biomech (Bristol, Avon). 2020 Aug;78:105063. doi: 10.1016/j.clinbiomech.2020.105063. Epub 2020 May 28. PMID: 32521283.

Okamura K, Fukuda K, Oki S, Ono T, Tanaka S, Kanai S. Effects of plantar intrinsic foot muscle strengthening exercise on static and dynamic foot kinematics: A pilot randomized controlled single-blind trial in individuals with pes planus. Gait Posture. 2020 Jan;75:40-45. doi: 10.1016/j.gaitpost.2019.09.030. Epub 2019 Sep 29. PMID: 31590069.

Unver B, Erdem EU, Akbas E. Effects of Short-Foot Exercises on Foot Posture, Pain, Disability, and Plantar Pressure in Pes Planus. J Sport Rehabil. 2019 Oct 18;29(4):436-440. doi: 10.1123/jsr.2018-0363. PMID: 30860412.