Flat feet, do you need insoles?

By Maria Josefina Canepa Bustos

MSc Senior Musculoskeletal Physiotherapist · physiotherapist

AHPRA registered · PHY0002918524

Paediatric Musculoskeletal Sports Rehabilitation · Overuse Sport Injuries Rehabilitation · Dry needling · Therapeutic exercise

Maria Josefina Cánepa Bustos is a Senior Musculoskeletal Physiotherapist with a focus on sports and paediatric musculoskeletal rehabilitation, with eight years of clinical experience across private practice, sports clubs, and academic settings. Holds a Master of Science in Advanced Professional Practice in Paediatric Musculoskeletal Health, alongside postgraduate qualifications in therapeutic exercise and university teaching, with a focus on young athletes, injury prevention, and performance-based rehabilitation in sport settings.

Last reviewed: 11 April 2023

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 physiotherapy may also help with flat feet, alongside or as an alternative to orthotics? There are different ways to manage flat foot symptoms, and it's worth understanding your options.

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).

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 can improve foot position and reduce the pain associated with flat feet while it's being worn. Take the sole away, and the arch drops back down, and symptoms can return. Orthotics can be genuinely helpful for acute episodes of foot pain, and for people with high workloads who need pain managed day-to-day (labourers, soldiers, athletes). They're a legitimate tool, though on their own they don't change the underlying strength or function of the foot.

Relying on highly structured shoes or insoles long-term, without also working on the foot's own strength, can mean the foot's intrinsic muscles and sensory nerves stay deconditioned, which is why some people notice more discomfort if they stop using them suddenly.

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, and aims to support lasting improvement. 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, and this can work well alongside physiotherapy, which focuses on addressing contributing factors as well as symptoms.