There are many conditions that plague today’s children and flat feet is one of them. Flat feet can be responsible for many chronic orthopedic problems as children grow into adulthood. I consider flat feet an infant development issue and most infant development problems do not expose their ugly heads until the person is over the age of 40; this makes it is particularly hard to convince parents that flat feet are actually a problem for infants. Since the brain relies on information from the extremities, I will explain below how flat feet actually cause misinformation from the foot all the way up to the brain, potentially causing any chronic orthopedic or visceral problem known today.


In most medical schools anatomy is taught by breaking the body down into individual muscles, bones and viscera.  In most cases the fascia is removed from all of these structures and thrown in the garbage. It is the fascia that links the entire human body together and without it life would cease to exist. Studying muscles, bones and viscera is important, but without the study of fascia it is pointless and quite honestly is the main reason for poor surgical and rehabilitation results.

The Deep Longitudinal System 

Due to fascial connections I rarely single out a muscle and instead describe fascial chains.  There are many important fascial chains in the body, but when treating flat feet, the deep longitudinal system takes precedence. The deep longitudinal system begins at the lateral malleolus with the following ascending attachments; peroneal muscles — biceps femoris —  sacrotuberous ligament — gluteal muscles —  thoracolumbar fascia —  paraspinal muscles— and finishing on the base of the skull through the suboccipital muscles. This is the deep longitudinal system and the reason why flat feet can cause dysfunction anywhere in the body.  Flat feet literally cause misinformation from the ground up, all the way to the brain!

The Cause Of Flat Feet

The cause of flat feet is debatable. In my opinion there are three possibilities: 1. Poor nutrition by the mother when the child is in utero.  2. From parents trying to speed up or interfere with infant development (most common in my opinion.) 3. Hereditary (least common.)  Since #1 and #3 are self explanatory I want to expand on #2. The sole purpose of infant development is to go from a fluid filled sack to developing into the only creature that walks on 2 feet. Infant development takes approximately 1 full year before the infant can walk. Infants are born without curves, without tonic or phasic muscles, without a functioning core and without arches in their feet.  It is during this first year process of infant development that the curves form, the muscles learn their purpose, the core integrates the upper and lower halves and, yes, the arches gradually form in the feet. To turn infant development into a contest and force a child to walk before its body is physically ready is the chief cause of flat feet and many other orthopedic dysfunctions.

What Can a Parent Due?

It is imperative to treat flat feet early in life. As soon as the child begins to walk and you notice flat feet, place the child in shoes that have a rigid rear foot support. This will help maintain the rear foot in proper alignment; also contact a qualified therapist that knows how to restore the function of the foot with manual therapy and corrective exercise. Here is a simple test that can be performed at home called the “credit card test” to check rear foot alignment. The card should touch the outer ankle bone and the side of the foot simultaneously. If the card hits the foot and not the ankle bone, the person has rear foot valgus (flat feet).

H3’s Approach To Flat Feet 

At H3 we use several approaches to correct flat feet. Many times with flat feet, the navicular bone needs to be adjusted. The navicular bone is like a keystone to an arch. Many times the navicular bone gets stuck in the up position and a proper manipulation can do wonders. Next the deep longitudinal system needs to be stretched; I try to get my clients to literally form a link from the outer ankle bone all the way up to the skull with the myofascial stretch of the biceps femoris. Once the deep longitudinal system is released there are many options for segmental strengthening of the medial gastroc/soleus, the 3 arches of the feet and all the small intrinsic muscles.

Proprioception and Awareness

Proper foot wear, manual therapy, myofascial stretching, and segmental strengthening are all part of a corrective exercise program for flat feet. However, proprioception and awareness also needs to be included in the program. General awareness of the feet with daily activities should be emphasized and proper proprioception/awareness drills for the different ligaments of the feet performed on a daily basis.

Contact The H3 Training And Learning Center

Unfortunately the medical establishment will tell you not to worry about flat feet. However, now that you know there is a direct link from the foot all the way to the base of the skull you can take responsibility for your own or your child’s health. If you or your child have flat feet and would like more information, contact H3 today at 954.566.0585 or email

Better Body. Better Feet. Better Life.

Dan Hellman MSPT, C.H.E.K Faculty