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4 Exercises to Help with Hip, Knee & Heel Pain from Flat Feet

Aug 23, 2019
by Liz Koch  
When you look at a house that has cracks in the walls, where do you look first to fix the issue???

The Foundation! Or for your body… your FEET

From working with mtn bikers, through The Ride Life, and being one myself, I have seen the impact feet can have on riders and their bodies. It is one of the points of contact with the bike and can play a big role!

**This article isn't going to talk about shoes, pedals, or type of attachment (platform vs clipless).**

Having a flat foot (overly pronated foot) is basically saying that your arch is caving in… Then this causes your knee to turn in… which then causes your hip to turn in … and pelvis stress.

Knee turning in: Means that many repetitions on the bike can cause knee pain and a lack of motor control of the leg

Hip Turning in: Means that you’re a placing your external rotators and abductors (aka your gluts) on stretch and can decrease their function

Pelvis stress: Means that your back can become the next stress point.

Flat Arch
Good Arch

These are all cracks in your walls of your house. Now you know that after you fix the foundation of a house you may have to fix the walls… aka…you may need to do other stretching and strengthening for the knees, hips, and low back to completely solve your issues in these regions.

Now… there is a reason why we have the ability to flatten our feet. This is our shock absorber to be able to walk and to run on uneven ground. But if we can’t come back out of it and regain our arch, we are not ready for the next impact and we are leaving our joints in a compromised position.

Now that you understand why flat feet can cause major issues… you ask, why are my feet flat? I’m going to go over some broad base ideas and give you an exercise to combat each main point. This isn’t an all-inclusive list, but a broad look to help most people.

Couple different reasons why you could have flat feet…

Ankle DF




1. Stiff Ankles: If you can’t move your knee over your toes then your body will collapse the arch to get the motion, turning your toes out and making you walk more like a duck. Lacking this movement can cause more stress on the knee, hip, and back.

Foot Muscles 2




2. Foot Muscle Weakness: There are also muscles in your foot that support the arch from there. These endurance muscles need to be able to get you through a ride.

Ankle Muscles




3. Ankle Muscle Weakness: There are muscles that come from the calf to the foot and help support the arch. If these muscles are weak then you will have more foot issues. These can be more power to help support your arch through bigger impacts, like landing from a jump.

Foot Ligaments

4. Very Flexible Feet: You could have more flexibility in your foot or could have stretched these out causing your foot to lose structure and support. Think of ligaments like straps that connect bone to bone… sometimes they break and some people have more bungie cords than straps. Therefore, these straps that should be supporting the arch are not and the foot muscles need to take up the slack or you need some outside support as well depending on the severity of the lack of support.


On a side note: Orthotics, Wedges…

There are many different opinions on this area.

Here are some reasons why an orthotic or support/wedge would be indicated:

- Your foot has a deformity/structural issue or pain (needs to be unloaded)
- You have a very flexible foot, you need some external support
- Your foot/ankle muscle’s endurance can’t keep up with your rides/daily life

Getting a wedge or an orthotic can help with foot soreness and can help with other issues up the chain (knees, hips, and back), but it can also cause more foot/ankle weakness. This can lead to less balance as a whole and an increased dependence on the orthotic.

When people get the arch support, the foot/ankle muscles don’t have to work as much, therefore, if you did need the arch support you need to keep strengthening your muscles!! Also, if your arch support is too stiff then you will lose the ability for your foot to shock absorb. On the other hand, if it is too soft, then you might not be giving yourself enough support.



Check out the Exercises for your Arch

Exercise 1: ½ Kneeling Ankle Stretch
Views: 1,219    Faves: 5    Comments: 0

Objective
- To test ankle movement and to then stretch ankle movement

Perform:
- Daily to loosen up ankle and decrease stress on arch
- Do 20 reps 1 sets

Things to Note:
- Place towel roll under arch for support
- Do not hold, pulse in and out of movement
- If it is stretching more the Achilles tendon do a wall calf stretch with towel arch support

Exercise 2: Pen Cap or Towel Grab
Views: 833    Faves: 5    Comments: 0


Objective
- To strengthen the muscles that are in the foot to support the arch of the foot

Perform:
- Daily
- Do 20-40 reps 1-3 sets pending on physical endurance

Things to Note:
- Stop and rest if foot is cramping, keeping heel down

Exercise 3: Ankle Arch Muscles
Views: 779    Faves: 5    Comments: 0


Objective
- To strengthen the muscles that come from the calf to support the arch of the foot

Perform:
- Daily
- Do 20-40 reps 2-3 sets

Things to Note:
- Stop and rest if your calf/foot starts the cramp
- Should feel muscles in your inner calf working or foot
- Heel stays on the ground

Exercise 4: Loaded Arch Support/Balance
Views: 811    Faves: 6    Comments: 0


Objective
- To understand how to implement the muscles for the arch support when standing

Perform:
- Daily
- Do 20-40 reps 1-3 sets pending on physical endurance

Things to Note:
- Stop and rest if foot is cramping
- Big toe base stays on the ground


About the Author:
Liz Koch, PT, DPT is a physical therapist that knows exactly what it is like to have pain. She has been to many PTs over her life, which directed her to becoming one. She has been a mountain biker since she was a kid and has recently opened up her own clinic in Western North Carolina, Blue Ridge BioMechanics. She wants to share knowledge so you don’t have to be in pain when riding and you don’t have to stop riding to get out of pain. She has focused this mission to Rad Mountain Biking Ladies on Facebook and through her online business, The Ride Life.
Let her know if you have questions.
*If you have pain please consult with a doctor or physical therapist for further evaluation, Liz Koch and companies are without liability if you injure yourself while performing these exercises*



28 Comments

  • 8 0
 I cant wait to put this into action. I have what I come to affectionately call a negative arch. My foot is so flat it rolls inwards. This is what I believe is a big contributor to ankle and knee pain in athletic shoes. the irritating part is I can find very many shoes in my size (16) that don't have crazy amounts of stability built in. Anywho thanks for this article!
  • 1 0
 Having feet as big as yours matching up with normal athletic shoes is a tricky subject. Men's shoes and proportions are designed on a size 9. When you get up to BIG feet like yours the scaling gets wonky, and you're outside of what is normal therefore normal athletic shoes aren't going to be the same/ perform the same as their normal sizes.

But to the point of the article, it makes it seem like you NEED to have an unmoving arch and having a low arch is going to cause you problems regardless, which it won't. "if you did need the arch support you need to keep strengthening your muscles" THIS SENTENCE IS NOT TRUE FOR EVERYTHING OR EVERYONE! There is SO MUCH variation in foot shapes and morphology before you even get to the how it interacts with the rest of your body. Also how your foot interacts with non flexing footwear (like a stiff clipless shoe or ski boot), versus a running shoe or sandal is a very different things. The rigid footbeds often used in ski boots are bad to put in flexible footwear. If you naturally have a static flat foot that is fine, your foot needs are different than people like me who have a dynamic high arch.

Source: I work in performance footwear working with people who've been developing and testing olympic level footwear for decades.
  • 1 0
 @NorCalNomad: Totally agree and there seems to be no significant correlation between foot pain and a low arch. These exercises may perhaps help you if you have foot pain but your arch is going to stay exactly the same. That is pretty old school to think that the size of the arch determines whether your foot is functional or not. I think Usain Bolts feet is pretty good example of that...
  • 1 0
 @mtirado17

It is def hard with a negative arch... or a very flat foot to get a shoe that supports you how you need. When ever someone has a significantly low arch, you don’t want to have a huge support. You foot won’t handle it well at all. I would look for more of a neutral (no support in the shoe) and then add in an orthotic or insert that fits the type of support that you can handle/need. I would also recommend strengthening your hips (gluts) to also support your ankles and knees. You can check out my YouTube channel for some good exercises.
  • 27 16
 Where's Abby?
  • 4 0
 Try this.

Stand feet together.

Relax

Tense glutes hard.

Try this a few times and notice how your feet naturally fork an arch.

Strong / properly functioning glutes can go a long way to addressing collapsed arches.

Combine this with trying to grip the floor with your feet.
  • 4 0
 Wow! This article was extremely insightful. Thank you. I was going to put in the work to do my own research but everything is already in here. Can't wait to try these exercises later. I have some of the flattest feet you'll ever see (absolutely not arch). In return this has impacted my knees (also over pronated) and my hip mobility. Just recently, I realized my arch/feet has to be impacting my mountain biking and you've just affirmed it.
  • 3 0
 I have flat feet, a history of plantar fasciitis, 4 knee surgeries o
to my right knee, and recently inured my back- I suspect my SI joint could be compromised. Are SI joint injuries common in the patient types that you describe? Thank you Liz!
  • 1 0
 Oh no! That sucks! 4 knee surgeries Frown

They can be but it is more likely that you need to work on some core strengthening to help with both back and SIJ issues. If you are more flexible as a whole they helping your feet can help but def will need some core strength as well.
  • 1 0
 @theridelife: I think you are right; I will start doing more core work. I am on vacation in S. Korea and am receiving my 2nd round of a acupuncture, tens stim, and cupping therapy. I also got a massage and am feeling so much better. Thank you
  • 2 0
 Many thanks for the article, it could be useful in my case. It's been over 1 year since I have chronicle knee pains (Kneecap tendon tendinitis)... Unfortunately there is nothing concrete to solve the issue, just grit your teeths.
I will try and see if it relieves the pain a bit! That would be great!
  • 1 0
 Are you also doing some hip strengthening as well?
  • 1 0
 @theridelife: To be honest, I have never practiced such exercices. I usually do some warm-ups and a bit muscle reinforcement, but nothing specific.
  • 2 0
 Thanks for the video! Am I right in thinking that foot flatness due to joint hypermobility is something I'm stuck with for life?

I stretch a lot and I'm generally pretty fit and strong, but over a 3-4 minute rocky downhill foot pain is the limiting factor for me. Ankle mobility is not an issue, although my calves and hamstrings are basically always tense if I haven't stretched then in the last 10 minutes.

I have cheap arch support inserts I got on Amazon and they help a bit but it still hurts.
  • 6 0
 This was super helpful!
  • 4 1
 Good article. I would recommend walking around barefoot as much as possible to build up the muscles in the foot to raise that arch.
  • 1 0
 I have flat feet, weak ankles (which I roll/sprain them often) very sore hips and knees. I'm also hypermobile. It all makes sense now!

Thank you so much for posting these excellent videos and exercises! I recently purchased a foam roller and have doing many of your other stretches and exercises as well! Please keep this stuff coming. It's very helpful!
  • 2 0
 Do you wear orthotics for day to day use? I have flat feet and couldn't live without them. Don't wear them when riding though.
  • 1 0
 @friendlyfoe: I do wear orthotics. However, I don't wear them mountain biking, dirt biking or snowboarding. But I do wear them hiking and for regular day to day stuff. Some of my shoes don't accommodate my orthotics. I can definitely feel it at the end of the day when I go without.
  • 5 0
 More of this please!!!
  • 2 0
 Agreed ????. I usually go looking for solutions once something comes up but would love more preventative exercises off the bike so I can be my best on the bike!
  • 3 0
 Pinkbike, I love these types of articles! So helpful. Im going to try some of these exercises.
  • 3 0
 Great stuff, love to have more functional exercises like this!
  • 4 0
 Thank you!
  • 2 0
 Awesome Liz! Keep it up!
  • 1 0
 This is great. As someone who has struggled for a very long time with flat feet, I'm looking forward to trying these.
  • 1 0
 good stuff keep this kinda thing coming ,diagrams and videos interest me ,anatomy always has.
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