Foot function has long been considered to predispose individuals to musculoskeletal injury. Specifically, foot pronation (flat feet) has been associated with conditions such as plantar fasciitis, Patellar tendonitis, and Achilles tendinopathy. Away from the ankle, foot pronation may also play a role in the of medial tibial stress syndrome (shin splints) and patellofemoral pain syndrome.
Anatomy of Flat Feet
Altering a foot from an arched to flat feet occurs with 3 mechanisms:
- Outward movement of the heel bone, known as eversion of the calcaneus
- Inward motion of the front of the foot, known as abduction of the forefoot
- Collapsing of the main foot arch, lowering of the medial longitudinal arch
The reduction of foot pronation (‘anti-pronation’) is a component of the proposed mechanism of action of taping and foot orthoses and is a possible treatment for those with flat feet.
A recent study from Australia analyzed the effects of foot taping and orthotics in 21 healthy young adults with flat feet. The results found the changes in taping and orthotics in people with flat feet:
1. Hindfoot Eversion
There was a small, but statistically significant increase in peak hindfoot eversion in the foot orthoses condition compared to the neutral shoe, however foot orthoses delayed the timing of peak eversion compared to the neutral shoe. There were no significant differences in hindfoot ROM between the shoe, taping and foot orthoses conditions. Simply put, the outward of the heel bone was delayed in the taping and orthotics group.
2. Dorsiflexion Across Midfoot/forefoot
Dorsiflexion across the midfoot/forefoot was reduced with the low-Dye taping and modified taping, but not with the foot orthoses. The low-Dye taping, modified taping and foot orthoses increased peak dorsiflexion of the 1st MTPJ. In layman’s terms, the mid and forefoot had reduced upward movement (dorsiflexion).
Overall, the taping and orthotics reduced, delayed or decreased peak movement at a few areas at the feet. This reduced motion was expected, as orthotics and tape control foot motion. However, how can orthotics and tape help flat feet?
3 Secrets on How Foot Orthotics and Taping Help Flat Feet
1. Biomechaincal Changes
Once again, if you create more rigid foot, then you’ll change the biomechanics of those with flat feet. Foot orthoses appear most effective acting on the hindfoot, while the effects of taping were more confined to the midfoot and medial longitudinal arch. This change can reduce tissue loading and risk of soft tissue injury.
2. Neuromuscular Changes
Many would think orthotics would alter flat feet more than tape, as orthotics are more rigid. However, the sense of having the tape all around the feet and touching the skin may alter neuromuscular changes. Once again, taping is in direct contact with the foot for the entire gait cycle, and the neuromotor effect stemming from enhanced plantar sensory stimulation and potential changes in muscle activation patterns cannot be discounted.
The third secret on how foot orthotics and tape help flat feet is the mental component. All treatments have a degree of the placebo effect. Tape and orthotics like have a larger mental or placebo effect as you can actually feel and see these items, so the mind will make you think they are working! Now, many knock the placebo effect, but if it helps, does it truly make a difference?
Now, the Bishop (2015) article cited only looked at adults with flat feet without pain or injury. How orthotics and tape alter flat feet biomechanics in those with injury and pain is not well researched. Future studies must assess how tape and orthotics alter those with specific ankle, foot, knee, hip, and maybe even low back injuries.
Also, many have pain and injury (or no pain/injuries) add inserts and leave them for years. Make sure you have a sound reason for using orthotics or tape for flat feet! Don’t just look for the simple solution, as flat feet can be improved with individualized foot strength, soft tissue, and neuromuscular training.
Don’t be a mummy or an orthotic cyborg!
Continue working on strength of the feet and if you have pain, see a physical therapist, as removing pain and receiving individualized exercises is essential. Here are a few of our favorite exercises for building relaxing overactive foot muscles for patients with foot pain!
Here is an exercise for intrinsic foot strengthening:
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- Bishop C, Arnold JB, May T. Effects of Taping and Orthoses on Foot Biomechanics in Adults with Flat Arched Feet. Med Sci Sports Exerc. 2015 Nov 4. [Epub ahead of print]
Written by Dr. John Mullen, DPT, CSCS