Effects of Short-Foot Exercises on Foot Posture, Pain, Disability, and Plantar Pressure in Pes Planus

in Journal of Sport Rehabilitation
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Context: Pes planus is a prevalent chronic condition that causes foot pain, disability, and impaired plantar load distribution. Short-foot exercises are often recommended to strengthen intrinsic foot muscles and to prevent excessive decrease of medial longitudinal arch height. Objective: To investigate the effects of short-foot exercises on navicular drop, foot posture, pain, disability, and plantar pressures in pes planus. Design: Quasi-experimental study. Setting: Biomechanics laboratory. Participants: A total of 41 participants with pes planus were assigned to the short-foot exercises group (n = 21) or the control group (n = 20). Intervention: Both groups were informed about pes planus, usual foot care, and appropriate footwear. Short-foot exercises group performed the exercises daily for 6 weeks. Main Outcome Measures: Navicular drop, Foot Posture Index, foot pain, disability, and plantar pressures were assessed at the baseline and at the end of 6 weeks. Results: Navicular drop, Foot Posture Index, pain, and disability scores were significantly decreased; maximum plantar force of midfoot was significantly increased in short-foot exercises group over 6 weeks (P < .05). No significant differences were determined between the baseline and the sixth week outcomes in control group (P > .05). Conclusions: Six-week short-foot exercises provided a reduction in navicular drop, foot pronation, foot pain, and disability and increment in plantar force of medial midfoot in pes planus.

The authors are with the Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Zonguldak Bulent Ecevit University, Zonguldak, Turkey.

Unver (banuukarahan@yahoo.com) is corresponding author.
  • 1.

    Banwell HA, Mackintosh S, Thewlis D. Foot orthoses for adults with flexible pes planus: a systematic review. J Foot Ankle Res. 2014;7(1):23. PubMed ID: 24708560 doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 2.

    Shibuya N, Jupiter DC, Ciliberti LJ, VanBuren V, La Fontaine J. Characteristics of adult flatfoot in the United States. J Foot Ankle Surg. 2010;49(4):363–368. PubMed ID: 20537928 doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 3.

    Golightly YM, Hannan MT, Dufour AB, Jordan JM. Racial differences in foot disorders and foot type. Arthritis Care Res. 2012;64(11):1756–1759. doi:

  • 4.

    Wiewiorski M, Valderrabano V. Painful flatfoot deformity. Acta Chir Orthop Traumatol Cech. 2011;78(1):20–26. PubMed ID: 21375961

  • 5.

    Tang SF-T, Chen C-H, Wu C-K, Hong W-H, Chen K-J, Chen C-K. The effects of total contact insole with forefoot medial posting on rearfoot movement and foot pressure distributions in patients with flexible flatfoot. Clin Neurol Neurosurg. 2015;129:8–11. PubMed ID: 25683316 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 6.

    Vulcano E, Deland JT, Ellis SJ. Approach and treatment of the adult acquired flatfoot deformity. Curr Rev Musculoskelet Med. 2013;6(4):294–303. PubMed ID: 23765382 doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7.

    Jung D-Y, Koh E-K, Kwon O-Y. Effect of foot orthoses and short-foot exercise on the cross-sectional area of the abductor hallucis muscle in subjects with pes planus: a randomized controlled trial. J Back Musculoskelet Rehabil. 2011;24(4):225–231. PubMed ID: 22142711 doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8.

    Song J, Hillstrom H, Secord D, Levitt J. Foot type biomechanics. Comparison of planus and rectus foot types. J Am Podiatr Med Assoc. 1996;86(1):16–23. PubMed ID: 8808320 doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9.

    Buldt AK, Allan JJ, Landorf KB, Menz HB. The relationship between foot posture and plantar pressure during walking in adults: a systematic review. Gait Posture. 2018;62:56–67. PubMed ID: 29524798 doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10.

    Ledoux WR, Hillstrom HJ. The distributed plantar vertical force of neutrally aligned and pes planus feet. Gait Posture. 2002;15(1):1–9. PubMed ID: 11809575 doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 11.

    Buldt AK, Forghany S, Landorf KB, Levinger P, Murley GS, Menz HB. Foot posture is associated with plantar pressure during gait: a comparison of normal, planus and cavus feet. Gait Posture. 2018;62:235–240. PubMed ID: 29573666 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 12.

    McKeon PO, Hertel J, Bramble D, Davis I. The foot core system: a new paradigm for understanding intrinsic foot muscle function. Br J Sports Med. 2015;49(5):290. PubMed ID: 24659509 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 13.

    McKeon PO, Fourchet F. Freeing the foot: integrating the foot core system into rehabilitation for lower extremity injuries. Clin Sports Med. 2015;34(2):347–361. PubMed ID: 25818718 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 14.

    Sudhakar S, Kirthika SV, Padmanabhan K, et al. Efficacy of plantar short foot muscle exercise among middle distance runners: A single blind randomized controlled, pilot study [published online ahead of print June 27, 2018]. J Bodyw Mov Ther.

    • Search Google Scholar
    • Export Citation
  • 15.

    Mulligan EP, Cook PG. Effect of plantar intrinsic muscle training on medial longitudinal arch morphology and dynamic function. Man Ther. 2013;18(5):425–430. PubMed ID: 23632367 doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 16.

    Sulowska I, Oleksy Ł, Mika A, Bylina D, Sołtan J. The influence of plantar short foot muscle exercises on foot posture and fundamental movement patterns in long-distance runners, a non-randomized, non-blinded clinical trial. PLoS ONE. 2016;11(6):e0157917. PubMed ID: 27336689 doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 17.

    Jung D-Y, Kim M-H, Koh E-K, Kwon O-Y, Cynn H-S, Lee W-H. A comparison in the muscle activity of the abductor hallucis and the medial longitudinal arch angle during toe curl and short foot exercises. Phys Ther Sport. 2011;12(1):30–35. PubMed ID: 21256447 doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 18.

    Cote KP, Brunet ME, Brunet ME II, Shultz SJ. Effects of pronated and supinated foot postures on static and dynamic postural stability. J Athl Train. 2005;40(1):41. PubMed ID: 15902323

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 19.

    Redmond AC, Crosbie J, Ouvrier RA. Development and validation of a novel rating system for scoring standing foot posture: the Foot Posture Index. Clin Biomech. 2006;21(1):89–98. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 20.

    Morrison S, Durward B, Watt G, Donaldson M. A literature review evaluating the role of the navicular in the clinical and scientific examination of the foot. Br J Podiatry. 2004;7(4):110–114.

    • Search Google Scholar
    • Export Citation
  • 21.

    Kulunkoğlu B, Firat N, Yildiz NT, Alkan A. Reliability and validity of the Turkish version of the Foot Function Index in patients with foot disorders. Turk J Med Sci. 2018;48(3):476–483.

    • Search Google Scholar
    • Export Citation
  • 22.

    Fiolkowski P, Brunt D, Bishop M, Woo R, Horodyski M. Intrinsic pedal musculature support of the medial longitudinal arch: an electromyography study. J Foot Ankle Surg. 2003;42(6):327–333. PubMed ID: 14688773 doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 23.

    Lee J-H, Cynn H-S, Yoon T-L, Choi S-A, Kang T-W. Differences in the angle of the medial longitudinal arch and muscle activity of the abductor hallucis and tibialis anterior during sitting short-foot exercises between subjects with pes planus and subjects with neutral foot. J Back Musculoskelet Rehabil. 2016;29(4):809–815. PubMed ID: 27002666 doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 24.

    Taspinar O, Kabayel DD, Ozdemir F, et al. Comparing the efficacy of exercise, internal and external shoe modification in pes planus: a clinical and pedobarographic study. J Back Musculoskelet Rehabil. 2017;30(2):255–263. PubMed ID: 27858680 doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 25.

    Lee D-B, Choi J-D. The effects of foot intrinsic muscle and tibialis posterior strengthening exercise on plantar pressure and dynamic balance in adults flexible pes planus. Phys Ther Korea. 2016;23(4):27–37. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 26.

    Panichawit C, Bovonsunthonchai S, Vachalathiti R, Limpasutirachata K. Effects of foot muscles training on plantar pressure distribution during gait, foot muscle strength, and foot function in persons with flexible flatfoot. J Med Assoc Thai. 2015;98:S12–S17. PubMed ID: 26387405

    • PubMed
    • Search Google Scholar
    • Export Citation
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