From the Guidelines
Prolonged standing, running, and walking can exacerbate pes planus (flat foot) symptoms, particularly if proper footwear and gradual activity increases are not implemented. These activities place repetitive stress on the foot's arch structure, potentially leading to increased pain, fatigue, and inflammation in individuals with flat feet. The arch of the foot normally helps distribute body weight and absorb shock during movement; in flat feet, this mechanism is compromised, causing the foot to roll inward excessively (overpronation) during weight-bearing activities.
To manage symptoms, supportive footwear with proper arch support is essential, and custom orthotic inserts may be necessary for severe cases, as suggested by guidelines for foot care in diabetes management 1. Taking regular breaks during extended periods of standing, implementing a gradual approach to increasing running or walking distances, and performing foot-strengthening exercises like toe curls and arch lifts can help build supporting musculature.
Recent guidelines on the prevention of foot ulcers in persons with diabetes suggest that a gradual increase in weight-bearing activity, such as walking, can be safe and beneficial for individuals at low or moderate risk of foot ulceration, provided they wear appropriate footwear and monitor their skin for pre-ulcerative lesions 1. This approach can be applied to managing pes planus, emphasizing the importance of gradual increases in activity and proper footwear to mitigate the risk of exacerbating symptoms.
Key recommendations for individuals with pes planus include:
- Wearing supportive footwear with proper arch support
- Gradually increasing weight-bearing activities to avoid sudden spikes
- Monitoring skin for pre-ulcerative lesions or breakdown
- Performing foot-strengthening exercises
- Considering custom orthotic inserts for severe cases
- Applying ice and using over-the-counter NSAIDs as needed for pain and inflammation management.
From the Research
Prolonged Standing, Running, and Walking in Pes Planus
- Prolonged standing, running, and walking can potentially exacerbate pes planus (flat foot) due to the increased stress and pressure on the foot and ankle 2.
- However, there is limited direct evidence to support this claim, and more research is needed to fully understand the relationship between these activities and pes planus.
Effects of Exercise on Pes Planus
- Short-foot exercises have been shown to be effective in reducing navicular drop, foot pronation, foot pain, and disability in individuals with pes planus 3.
- These exercises can also increase the cross-sectional area of the abductor hallucis muscle and the strength of the flexor hallucis 4.
- Foot orthoses combined with short-foot exercise may be more effective than foot orthoses alone in improving the strength of the abductor hallucis muscle 4.
Management of Pes Planus
- Non-surgical interventions, such as orthoses and physiotherapy, may be beneficial for certain groups of individuals with pes planus 5.
- Foot orthoses have been shown to improve physical function, reduce pain, and alter loading and impact forces in individuals with flexible pes planus 6.
- However, more high-quality research is needed to fully understand the efficacy of foot orthoses in managing adult flexible pes planus 6.