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Writer's pictureJoe Taylor

Flat feet, do you need insoles?


Having trouble running or walking without foot pain?


Have you been told you have a flat foot?


Have you been pitched an orthotic insert for your shoe?


BUT…


Has anyone told you that you can rehabilitate a flat foot with physiotherapy? That you don’t need to rely on an expensive splint that gets lost, doesn’t fit in our new shoes that wears down and must be replaced? Not to mention that an orthotic doesn’t treat the source of your problem.



What does ‘flat feet’ mean?




What does flat feet mean?


Flat foot can be described simply as dropped arch height and an inward roll of the foot, although it can be a little more complicated than that. Other names that you may have heard of are Pes Planus or Pes Planouvalgus.




People with symptomatic flat feet will experience foot pain in the base of the heel or along the fascia that spans the arch of the foot. People may also experience pain in the shins, knees or hips due to the altered mechanics of the foot during walking and running.


Most people will experience little to no symptoms of flat feet, however the change in foot posture can have upstream affects at the knee, hip and back. The effects of which may not be obvious until they reach a tipping point and either an injury occurs, or a chronic condition develops (tendonitis or shin splints).




Flat foot treatment



Why do Orthotics work?


The orthotic acts as a bolster and physically pushes the arch of the foot upwards placing it in a better position. This in the short term will improve foot position and reduce the pain associated with flat feet. That’s it. Take the sole away and the arch drops, and the pain returns. This may help with acute episodes of foot pain and can help people with high workloads manage their pain (labourers, soldiers, athletes) but ultimately the orthotic has no lasting change on the condition itself. In fact, becoming reliant on highly structured shoes with or without insoles deconditions the foots intrinsic muscles and sensory nerves further, meaning when you take the insole away you will probably be in more discomfort!


So, how can Physiotherapy build the arch in our foot?


Physiotherapy aims to build the arch in your foot by training the soft tissues in your foot and lower limb. This can take some time, but it makes lasting changes. These therapies involve strengthening, stretching, mobilisations and activities that redevelop the neural functions in your foot such as proprioception. Modern footwear deconditions the foot and its structures and graded exposure to flat soled shoes and bare foot walking is also incorporated into the rehabilitation program.


Our physiotherapists can assess your feet and develop a personalised evidence-based program that involves activity modification, load management, stretching, strengthening of the tissues that support the arch of your foot. Using orthotics can help with your day-to-day function and reduce pain but in our belief treating the source of the problem is more effective than simply treating symptoms.




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