Flat feet are a condition where the arch of the foot appears flattened. This causes the foot to roll inwards as it contacts with the floor in support of the weight of the body, and is the main clinical feature of excessive pronation. A flat foot is a condition in which the foot doesn’t have a normal arch. It may affect one foot or both feet.

Most people have a gap between in the inner side of the foot and the ground when they are standing. This is referred to as an “arch”. Feet that have a low arch or no arch at all are referred to as flat feet or fallen arches (pes planus) and the foot may roll over to the inner aspect.

Types of Flat feet:

  • Congenital flat foot is a condition that one is born with.
  • Acquired flat foot, develops over time, rather than at birth and is likely to cause pain and other symptoms – sometimes including the development of arthritis in the feet.

Causes of Flat Feet

  • It may be hereditary, i.e passed on through generations.
  • In most cases it is caused through a biomechanical complaint (abnormal walking) such as Fore Foot Varus. This is a condition in which the subtaler joint in the foot over pronates (rolls in too much).
  • A ruptured tendon (tibilias posterior) can lead to a flat foot.
  • Cerebral palsy, spins bifida and muscular dystrophy can also lead to a flat foot condition.
  • Trauma or injury from sports and even improper footwear can influence the foot towards pronation and eventual flattening.

Signs and symptoms

  • Your feet tire easily or become painful with prolonged standing.
  • It’s difficult to move your heel or midfoot around, or to stand on your toes.
  • Your foot aches, particularly in the heel or arch area, with swelling along the inner side.
  • Pain in your feet reduces your ability to participate in sports.
  • You’ve been diagnosed with rheumatoid arthritis; about half of all people with rheumatoid arthritis will develop a progressive flatfoot deformity.


Many would say that there is really no way to prevent flat feet. However, the field of pedorthy and podiatry would probably disagree and recommend that orthotics be used to minimize the  speed at which the feet move further into pronation.

Treatment of Flat feet

  • The most important aspect of treatment is determining the exact type or underlying cause of flat feet that you have, and this can be examined through clinical examination and special imaging studies (e.g., x-rays, CT, and/or MRI).
  • Conservative treatment is used in the vast majority of flat foot cases, and consists of treatments such as orthotics, shoe recommendations, anti-inflammatory measures and special strengthening exercises.
  • Commonly called foot orthotics, these are interchangeable among your shoes and may provide more support because they’re molded to the contours of your feet. Orthotics come in three types: rigid, semi-rigid and soft.
  • Surgery is rarely required, and is reserved only for the most severe types of flat foot that do not respond to conservative therapy

Facts about flexible flat feet

  • Flexible flat feet are a common, usually painless condition that is often normal.
  • Corrective shoes or inserts do not “create” an arch.
  • Flexible flat feet will not interfere with a child’s ability to learn to walk or play sports.
  • Shoe salespersons may tell you expensive shoes will help you walk better. This is not true. Regular, inexpensive shoes may be worn too, if they offer good support.
  • If you have questions about shoes, always check with a professional.

Home remedies for flat feet

Wear good shoes. This is the most important remedy. Make sure that they are comfortable and fit properly.

Can reflexology help?

Since reflexology has a relaxing and beneficial effect to the whole body, and because our techniques are applied to the feet, they are definitely the beneficiaries of the soothing relaxation reflexology offers.

Although the focus of reflexology is the whole body, sore aching feet will appreciate what a great reflexology session can provide in terms of stress relief and therefore pain relief.

It’s important to remember that because we don’t treat, the benefits to the feet are a bonus – but one which everyone can enjoy.

As with a lot of pathologies or deviations from the norm, flat feet may not begin with the feet, unless the condition is congenital.

As we age there is a tendency for the feet to pronate, but most of us who have healthy arches will likely keep them, as long as we don’t abuse our feet.

Unless there are deformities in the bones that do not support the structure on the arch – the only thing that will create it or remove an arch is the tissue that surrounds it. Bones can’t keep themselves in place without a collective effort (cranial bones may be the exception because of their intricate system of interlocking sutures).

So what keeps the foot arch in shape (or out of shape)? Ligaments, tendons, muscles and connective tissues.

Let’s look at which of these supports the arch…

Firstly, ligaments connect bone to bone, and there is a lot of ligamentous attachment around the arch of the foot to keep it stable.

Next, we have 2 very important muscles whose tendons both attach to the base of the first metatarsal. One comes from the outside and the other from the inside (front) of the leg and together they form a stirrup that supports the medial arch of the foot.

The “peroneus longus” is the outer muscle and the “tibialis anterior” is the inner one that form a “continuous” support because they both attach, at their distal ends, to the same bone: metatarsal #1.

So if the foot is flat, one of these muscles is probably weak and the other is possibly in spasm or at least tight.

At this point you might refer your client to a massage therapist, however, many are not familiar with, nor trained in the intricacies of the feet.

An osteopath is likely your best recommendation (or a chiropractor). Most in the medical profession will defer to the use of orthotics to correct the misalignment.

Orthotics can support the structure and relieve a degree of the pain, but they’re not aimed at correcting the cause of the problem.

Both an osteopath or a chiropractor should be able to take a look at the structural alignment, or rather misalignment and offer treatment and exercises to recalibrate the back, or hips, or legs, or whatever the cause is found to be.

I’ve personally met someone with flat feet who gave themselves an arch. As he described it, he did exercises that lengthened his peroneus longus muscle and toned or tightened his tibialis anterior muscle.

Admittedly, he had to exercise every day, and if he didn’t (or even if he stayed on his feet for more than 8 hours) his pronation would return.

A simple exercise to strengthen the tibialis anterior is to stand with both feet on the ground and lift only your toes (extension).

A way to lengthen the peroneus longus is to stand with both feet on the ground and roll your feet onto their outside edge (supination).

By doing this daily, he swore that his arch would remain elevated throughout the day and that the pains he felt in his back, legs and feet were alleviated.

Of course this is just one person’s approach and may not work for everyone. That’s because there can be many different reasons for flat feet.

Reflexology is a complementary modality that will work well in conjunction with just about any medical treatment. It’s been found successful in relieving the pain that accompanies many pathologies and treatments. Flat feet are just one of many.

Think of your client’s highest good and join forces with other professionals so that the best results can be achieved.

Their feet will thank you for it.

In addition, don’t forget that with reflexology, the magic is in the details. For structural issues, I pay attention to the reflexes to all the spinal reflexes in addition to the reflexes to the legs, hips and knees, arms and shoulders.

  1. Be attentive and listen for what your clients needs.
  2. Be clear about your reflex location.
  3. Never work beyond your client’s pain threshold.
  4. Hold the healing space as sacred.
  5. And, enjoy your wonderful reflexology skills.