Flatfoot (Pes Planus)

Explanation of Diagnosis

Flatfoot (pes planus) means the arch of your foot becomes low or collapses, making the foot look flatter than usual when you stand. This can happen because the foot’s supporting ligaments and tendons (often including the posterior tibial tendon) aren’t holding the arch as well, especially during weight-bearing. Some people are born with a flexible flatfoot, while others develop it over time from wear and tear, aging, injury, genetics, or increased body weight. Common symptoms include inner-arch or inner-ankle aching, foot fatigue with standing, shoe wear on the inside edges, and sometimes heel pain or stiffness.

Specific Work Modifications

• If your job involves standing, choose supportive footwear and consider an over-the-counter or custom arch support to reduce arch collapse.
• Use an anti-fatigue mat if you must stand in one place for long periods.
• Take short sit breaks every 30 to 45 minutes to “reset” symptoms, especially after long standing or walking.
• Alternate between sitting and standing tasks when possible to avoid continuous load on your feet.
• Avoid prolonged walking on uneven ground, ramps, or sloped surfaces when your symptoms flare.
• If you have to climb stairs, keep the load light and slow down, using handrails as needed.

Specific Activity Modifications

• Temporarily reduce high-impact activities like running, jumping, and intense court sports if they increase arch or inner-ankle pain.
• Choose lower-impact workouts first, such as swimming, cycling (with good supportive shoes), or using an elliptical.
• Avoid barefoot walking on hard floors; use supportive shoes or supportive footwear indoors.
• During hobbies that involve long standing (fishing, fairs, gardening), plan periodic breaks and wear consistent arch-supporting footwear.
• When you return to activity, progress gradually and stop if pain changes your walking pattern.

Recommended Supplements

• Omega-3 fish oil, 1 to 2 grams per day, may help support healthy inflammation balance and recovery.
• Vitamin D3, commonly 1000 to 2000 IU daily, is useful if your levels are low and supports bone and muscle health.
• Calcium, typically 500 to 600 mg per day if you cannot meet needs through food, supports bone strength.

Recommended Nutrition and Hydration

Diet Recommendations

• Aim for a protein-rich diet (for example, eggs, yogurt, beans, chicken, fish, or tofu) to support tissue repair.
• Choose colorful fruits and vegetables and other sources of antioxidants (berries, leafy greens, peppers) to support recovery.
• Include healthy fats like olive oil, nuts, seeds, and fatty fish to support inflammation balance.
• Limit highly processed foods and sugary drinks when possible, especially if they worsen swelling or general aches.

Hydration Tips

• Drink water regularly through the day, and add fluids before, during, and after longer work or exercise sessions.
• If you sweat a lot, include electrolytes from foods (salty soups, milk, yogurt) or an electrolyte drink as needed.

Home Exercise Prescription

Do these exercises about 4 to 6 days per week, and keep them comfortable rather than painful.

1. Short-foot exercise: While standing or seated, gently “lift” and narrow the arch by pulling the forefoot slightly toward the heel; don’t curl the toes, hold 5 seconds, repeat 10 times.
2. Calf stretch (straight-knee and bent-knee): Stand facing a wall, keep one heel down, and stretch the calf; do 30 seconds each position, 2 rounds per side.
3. Towel scrunches or toe curls: With a towel on the floor, use your toes to scrunch it toward you, then release; do 1 to 2 minutes, 1 to 2 sets per side.
4. Heel raises with support: Hold a counter for balance, slowly rise onto your toes, pause 1 to 2 seconds, and lower with control; do 8 to 12 reps, 2 sets.
5. Ankle mobility (ankle circles): Sit or stand supported and make slow circles with your ankle to the right and left; do 30 to 45 seconds each direction per side.

Stop if you feel sharp pain, significant worsening, or a sudden change in how your foot loads.

Helpful Books

• "Explain Pain" written by David Butler and Lorimer Moseley
• "Running Anatomy" written by Jay Dicharry
• "Becoming a Supple Leopard" written by Kelly Starrett
• "The New Rules of Lifting" written by Lou Schuler and Alwyn Cosgrove