If you type the term “flat feet” into a Google search, Google’s top three autosuggestions are “flat feet surgery”, “flat feet pain”, and “flat feet shoes”. This demonstrates how hopeless people can feel about their feet. There are two main philosophical camps for dealing with a flat foot, which almost completely oppose each other. One side recommends directly supporting the fallen arch in the form of orthotics, motion control shoes, and other means of artificially providing cushion and arch maintenance. On the other side, an argument is made for more challenge to the flat foot with exercises, minimalist shoes, and frequent barefoot walking. So which strategy should you prescribe to?
What is a flat foot or fallen arch?
A flat foot or a fallen (medial longitudinal) arch is a biomechanical situation where the inner support of the foot excessively deforms when weight is placed on it. In other words, when stepping on the flat foot, the foot and ankle want to dive inwards. This is caused by one, or both, of the following:
- The joints and ligaments, or structural arch, of the foot have extra laxity, and cannot support the force of weight being placed on the foot and/or
- The posture muscles, or functional arch, of the foot are weak, and cannot support the force of weight being placed on the foot. These muscles work in a similar way to the spine muscles that hold you in good posture when you sit up straight (or try to at least).
In reality, these two “arches” are actually working together in the same system. The reason we can separate them into two categories is that the functional arch is the portion you have control over. The structural arch is the portion you cannot control (without the intervention of corrective surgery, which by personal experience is not a road you want to take unless absolutely necessary). The cool part is that the one you have control over (the functional arch) is the one that most people can improve to get out of pain! That’s good news, right?
How do I know if I have a structural arch or a functional arch weakness?
That is a good question. The honest truth is that you should consult with an expert functional rehab doctor, such as those at Norwood Chiropractic & Sports Injury Center (see what I did there?). However, there are some tests you can perform at home to give you a good idea about where you stand (man, I’m on fire!).
Try the following tests to see if you have a structural or a functional arch weakness:
- Stand on both feet and relax! Isolating the structural arch (remember, joints and ligaments only) requires you to relax the muscles of the foot while you’re standing. If you stand on both feet and completely relax the foot muscles, what happens to the inner arch of the feet? Do they maintain a nice arch shape, or does the foot dip to the floor? Does the inner part of the foot touch the floor? The more the arch drops, the more looseness there is in the structural arch. This is not a death sentence! Keep reading!
- Stand on one foot, and what happens? When you balance on one foot, does the foot immediately cave inwards? Or are you able to resist that pressure and maintain the foot positioning? Do you have trouble balancing on one foot in general? If the foot caves in and balancing is difficult, there is a functional arch weakness. This means the postural muscles of the foot are not strong enough to resist the force of standing.
Why do I have foot pain?
If you failed one or both tests above by not having the ability to maintain your foot arch, you’re not alone. Everyone who is interested in reading this post is most likely going to fail one or both of these tests, even I did! What matters is that you care about identifying the cause of your foot pain.
Luckily for us, we can improve our foot posture strength and this significantly reduces foot pain in the majority of people 
with flat feet. Most foot pain from flat feet comes from being over-supported and having under-stimulated postural muscles in the foot. Maybe the minimalist shoe camp isn’t always right when it comes to running and active design footwear. However, the thing they get right is that the foot needs to be stimulated daily or it will get weak. In other words, if you don’t use it, you lose it. Much of our flat-footed foot pain (say that 5 times fast) comes from wearing cushy shoes developed for fad trends, style, or from never leaving the confines of footwear.
There is surprisingly little research behind motion control shoes and long-term use of supportive orthotics. Private companies are not concerned with your daily foot strengthening regiment. In my opinion, they are concerned about the effectiveness of their marketing campaigns and quarterly growth and profit margins. The bottom line is that you can control your foot pain, and there are professionals out there qualified to help you do it.
