Flat Feet Massage

A Flat Feet Massage is a manual therapy approach aimed at alleviating symptoms and improving function in individuals with pes planus (flat feet). This condition is characterized by a reduced or absent medial longitudinal arch, leading to biomechanical changes, pain, and fatigue. Massage addresses musculoskeletal compensations and helps manage discomfort associated with flat feet.​

Signs & Symptons

• Hypermobility or collapse of the medial arch

• Pronated foot posture

• Pain at the plantar surface, arch, heel, or ankle, especially after activity

• Fatigue and stiffness in feet and calves

• Swelling along the inside of the ankle or foot

• Abnormal shoe wear patterns, often with more wear on the inner edge

• Associated conditions: plantar fasciitis, shin splints, iliotibial band contracture, and Achilles tendonitis.​

Contraindications

• Avoid mobilizing already hypermobile joints

• Do not overstretch tibialis posterior and anterior muscles (can worsen pronation)

• Avoid direct heat and deep friction if plantar fasciitis or significant inflammation is present

• Friction massage is contraindicated when a client is on anti-inflammatory medications.​

Assessment

• Observe for pronation throughout gait and weight-bearing activities

• Assess for hindfoot valgus (increased with severity)

• Check for medial arch flattening, talar head prominence, and forefoot abduction

• Palpate for tenderness at spring ligament, navicular, plantar fascia, and first metatarsal head

• Test active range of motion (eversion often increased; limited dorsiflexion if severe)

• Strength testing: reduced in tibialis anterior/posterior and foot intrinsic muscles

• Special/orthopedic testing can help distinguish between functional and structural pes planus.​

Treatment

• Massage compensatory muscles such as gastrocnemius, soleus, peroneals, and foot intrinsic muscles using myofascial release, deep muscle stripping, effleurage, and petrissage

• Release trigger points and adhesions in the lower leg and foot

• Gentle joint play or mobilization on hypomobile structures (not hypermobile areas)

• Stretch shortened muscles (gastrocnemius, soleus, peroneals)

• Strengthen weak muscles, especially tibialis anterior/posterior and foot intrinsics

• Use circulatory massage for swelling or to increase tissue health

• Avoid techniques that increase laxity or strain the arch’s passive structures.​

Self Care

• Contrast foot baths after extended stress or activity; ice application to inflamed areas

• Strengthening exercises for tibialis anterior, tibialis posterior, and intrinsic foot muscles

• Stretching routines for calves and peroneals

• Self-massage of the leg, foot, and ankle to maintain circulation and flexibility

• Arch supports or orthotics in footwear to relieve stress on arches

• Avoid prolonged activities that strain the medial arch; prioritize proper footwear