Flat Feet Massage

flat-feet-massagePes Planus or Flat Foot is a decreased medial longitudinal arch and a pronated hind foot (aka “flat foot”).

Causes of Flat Feet:

  • hyper mobility
  • poor biomechanics of subtler joint and metatarsal joint
  • shortened gastrocs, soleus, or Achilles
  • weakness in tibialis posterior
  • congenital bony abnormalities in foot
  • congenital bony abnormalities in leg and thigh
  • poor posture
  • nerve lesions causing paralysis or muscle weakness
  • trauma
  • poor footwear  flat feet massage flat foot massage for flat feet 

Flat Feet Massage: SIGNS & SYMPTOMS

  • hypermobility of medial arch and pronated foot
  • pain may be present in plantar surface, usually with overuse and fatigue
  • short peroneus longus, peroneus brevis, peroneus tertius, gastrocnemius, and soleus muscles
  • lengthened and weak tibialis posterior, tibialis anterior, long toe flexors, and intrinsic muscles of the foot
  • other conditions present (plantar fasciitis, shin splints, and iliotibial band contracture)


  • mobilizing hypermobile joints is contraindicated
  • do not stretch tibialis anterior and posterior. Allows increased pronation of foot
  • avoid heat on plantar surface when fasciitis is present
  • friction massage technique when client is on anti-inflammatory medication is contraindicated

 Flat Feet Massage: ASSESSMENT


  • pronation occurs throughout entire gait cycle
  • mild pes planus: 4-6 degrees hind foot valgus
  • moderate pes planus: 6-10 degrees hind foot valgus
  • severe pes planus: 10-15+ degrees hind foot valgus
  • Achilles tendon= valgus
  • internal tibial torsion possible
  • valgus at knees
  • internal rotation at hip possible
  • medial arch is flat; foot pronated
  • talar head bulges medially. Redness or callus where shoe rubs talar head
  • valgus at first metatarsal joint
  • forefoot abduction
  • mortons foot
  • Second metatarsal longer than the first


  • tenderness at spring ligament, navicular, calcaneus attachment of the long plantar ligament and plantar fascia, first and second metatarsal head and first metatarsophalangeal joint.
  • heat local to first metatarsophalangeal joint with bunions and on plantar surface if plantar fasciitis is present
  • thick, rough texture of skin over talar head and the first and second metatarsal heads
  • hypertonic and lengthened intrinsic foot muscles, tibialis anterior, tibialis posterior, and long toe flexors
  • shortened and hypertonic gastrocs, soleus, peroneus longus, peroneus brevis, and peroneus tertius
  • trigger points present in peroneus longus and brevis


Active Free:

  • Eversion in non-weight bearing calcaneus greater than 10 degrees
  • Dorsiflexion of ankle limited with severe pes planus
  • Increased internal rotation with femoral ante version

Passive Relaxed:

  • Tarsal joints and other joints of medial longitudinal arch are hypermobile
  • Plantarflexion and dorsiflexion reduced with restricted ankle joint capsule
  • Pain when passive eversion of calcaneus, supination of the foot and extension of toes with low grade inflammation of ligaments or plantar fascia
  • Hypomobility in pronated superior tibiofibular joint
  • Increased internal rotation of hip with femoral anterversion
  • External rotation of hip decreased

Active Resisted:

  • Reduced strength of tibialis anterior, tibialis posterior, and extensor hallucis longus


  • test for structural or functional Pes Planus
  • morton’s neuroma

 Flat Feet Massage: Treatment Goals

  • decrease SNS firing, fascial restrictions, pain, HT, TP’s, adhesions
  • massage compensating structures
  • treat other conditions, if any
  • stretch shortened muscles
  • increase circulation, esp. to weak, taut structures
  • mobilize hypomobile joints

Flat Feet Massage Therapy Treatment:


  • gastrocs/soleus:
  • MFR, DMS, Effleurage, Petrissage
  • . Stretch (+peroneals)
  • foot: Repetitive effleurage


  • joint play  tibiofibular joint/ankle
  • Use Stimulating Techniques: Tibialis anterior/posterior, Toe flexors intrinsic foot muscles (medial arch)
  • Passive Stretch: gastrocs/soleus and peroneals
  • Circulatory massage techniques to the whole leg

 Flat Feet Massage: Homecare


  • contrast foot baths after prolonged stress
  • apply ice local to inflammation


  • tibialis anterior/posterior
  • intrinsic foot muscles


  • gastrocs/soleus
  • peroneus longus, brevis, and tertius


  • avoid activities that stress medial longitudinal arch
  • arch support
  • self massage leg, foot, and ankle