Normal vs. Pathological Flat Feet
Flexible flat feet (arch appears when tip-toeing) is extremely common in children and usually benign. Rigid flat feet (no arch with tip-toeing) or flexible flat feet with pain, tiredness, or altered gait mechanics warrant physiotherapy assessment.
Physiotherapy Assessment
Foot posture index, arch height ratio, heel rise test, and dynamic foot mechanics during walking are assessed. Hip and knee alignment, muscle strength (especially Tibialis Posterior), and ligamentous laxity are evaluated.
Physiotherapy Intervention
Shortfoot exercise (activating the intrinsic arch muscles), heel raises, single-leg balance on foam, and toe spreading exercises progressively build the muscular support for foot arch development.
Footwear Advice
Barefoot walking on varied surfaces (grass, sand, pebbles) is actually beneficial — it stimulates intrinsic foot muscle activity better than supportive shoes. Avoid overly supportive shoes that prevent natural foot muscle function.