Pilates for Flat Feet

Pronating too much, or having flat feet, may contribute to foot pain, knee pain, hip pain or back pain.  Whether you are a pilates participant or a pilates instructor, there are some great exercises to help promote great foot control.

The most common biomechanical imbalances leading to overpronation are:

  • Weak later fibers of the gluteus medius muscle
  • Weak gluteus maximus muscle
  • Weak adductors
  • Weak vastus medialis and obliquas
  • Tight soleus and gastrocnemius muscles and sometimes hamstrings
  • Poor eccentric control of the tibialis posterior muscle
  • Overuse of the hip internal rotators, including TFL

Oftentimes, the femur (upper leg bone) rotates inwards too much so the tibia (lower leg bone) has to rotate outwards to compensate and the foot tends to collapse into pronation too early which a person may notice when walking.

So, the goal is to release, rebuild and retrain.

Release, or stretch, the hip internal rotators, calves and hamstrings.

Rebuild, or strengthen, the external hip rotators, buttocks and adductors.

Retrain a proper movement pattern that doesn’t allow the femur to roll inwards, the tibia to roll outwards and the foot to collapse.

Following are some examples of retraining exercises:

Footwork: When you straighten your knee your upper and lower leg bones need to rotate one way or the other (depending whether your foot is in contact with something or not) in order to make the knee joint accommodate your movement.  If someone already presents with too much femoral internal rotation (kneecaps tend to point inwards)  and tibial external rotation with the tendency for the foot to move into too much pronation, it will be more difficult for them to keep all the pieces in place when straightening the knee.  To help facilitate this, maintain contact with the ball of the 1st metatarsal head (the ball of the big toe) at all times, especially when straightening the knee.  A footboard allows for better overall contact and therefore feedback for yourself or your client.  When using high half toe, have the client hold a small towel or a small ball between their inside ankle bones and instruct them to not let it move. This will help them fire up their peroneal muscles (the muscles on the outside of the lower leg) thereby keeping their heel in line with the inside of their forefoot.

Ankle Press on the chair allows you to strengthen the eccentric control of the soleus muscle which is important during gait following heel strike when the foot is lowering to the ground.  Make sure the movement is slow and controlled using the tibialis posterior and soleus muscles to ensure there is no shaking.  Ensure the inside of the heel stays in line with the inside of the big toe and both sides of the foot stay in contact with the pedal at all times.

Cadillac, feet in straps, lift and lower in side lying. This is a good position to monitor whether or not the femoral head is bouncing around too much in the socket.  Using your fingers, lightly grasp the greater trochanter.  As you perform the lift and lower movement, notice whether or not the femoral head is moving in a rotational movement. You want to feel little to no movement at this point.  If there is too much movement, the femoral head is not secure which means everything below this will likely be moving too  much as well.

Standing roll downs are a nice way to become aware of your feet.  When standing, find even contact between the right and left feet with slightly more weight towards the heels and the rest divided between the big toe side and the baby toe side.  While maintaining contact with the head of the big toe, imagine a small balloon placed just underneath the inside arch of your foot so it gives it a slight lift upwards (to keep you out of too much pronation).  As you move through your roll down, maintain this slight lift beneath the arch and allow your toes to relax so they are not feeling as though they need to grab on for stability.

Try these exercises to turn your flat feet into happy feet!

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