14-minute Neuro #50: "Is flatfoot a hindrance to performance?"

Introduction: Is flatfoot a hindrance to performance?

Welcome to this new episode of 14-Minute Neuro. Today, Romain and I tackle a crucial question raised by a post I shared in my story: is flatfoot really a hindrance to performance? This inquiry comes from a client whose goal is to join an elite police unit, and who presents with flatfoot.

We will explore how to identify a "true" flatfoot, its potential biomechanical consequences on the body, and, most importantly, strategies to address it, going far beyond just using orthotic insoles.

Identifying and assessing flatfoot

To begin, it is essential to define what flatfoot is and how to observe it. Romain shares his approach, which starts with a visual assessment both statically and dynamically. We specifically observe the alignment of the knees and ankles to detect any potential compensations.

A flatfoot may be morphologically flat but functional, or conversely, may not function properly. Dynamic tests, such as observing the Djian angle and analyzing walking phases, are crucial to understanding foot mechanics and their impact on propulsion.

The importance of history-taking and functional tests

The case of our client illustrates this issue well: pain in the feet, knees, hips, and lower back arises after prolonged, even modest, walking. This highlights the importance of history-taking (gathering medical history) and testing. The absence of permanent orthotic insoles does not help the brain correct foot physiology, which can lead to pain and compensations.

Tests including bipodal and unipodal support, as well as evaluating primitive plantar reflexes, are fundamental. A non-integrated "low arch flat foot" can hinder proper weight distribution, affect gait, and even have repercussions on hip and jaw mobility.

Flatfoot and performance: a matter of imbalance

In our view, flatfoot is a sign of underperformance if all tests reveal a lack of plantar tone and issues with non-integrated primitive reflexes. This indicates an imbalance at the level of the central nervous system and biomechanical compensations that need to be corrected, not just with insoles, but through targeted exercises.

It's crucial to look at foot dynamics. If you don’t know how to walk correctly, you won’t be able to run efficiently. Feet have a tremendous impact on the rest of the body. We draw inspiration from the work of Gary Ward (Anatomy in Motion) and Shawn Neff (Iron Systems) to understand foot pronation and supination.

Pronation and the plantar tripod

Gary Ward emphasizes that pronation is a movement initiated by gravity and controlled by the supinators, the most important of which is the gluteus. Ineffective pronation can lead to gluteal amnesia. He also highlights the importance of the plantar tripod (the three points of contact of the foot) for optimal function. Observing calluses can provide clues about the distribution of pressure points.

Shawn Neff, on the other hand, approaches pronation and supination in relation to other muscle chains, connecting pronation to internal rotation, adduction, and flexion, and supination to abduction, external rotation, and extension. He emphasizes the holistic movement of the foot all the way to the opposite hand.

Correction strategies and rehabilitation

Correcting flatfoot involves sensory and neuromotor rehabilitation. We emphasize working on "torques" on the ground, which generate isometric components and improve foot mechanics. Isometric exercises are a powerful tool in neuro-performance.

Simple exercises, such as using toe spacers or a tennis ball under the foot, can help regain awareness of one’s body in space. The foot is a complex structure, containing a quarter of the bones in the human body and numerous joints. It is essential to take care of it to avoid negative adaptations, such as bunions.

Working the foot in all spatial planes

Bill Hartman, a fascia expert, emphasizes the importance of working the body in all spatial planes: sagittal, frontal, and transverse. The latter two are often neglected in strength training. Working on "matrix" exercises (toes pointed in various directions) is highly relevant for mobilizing fascial chains and restoring optimal foot function.

It is essential to observe the athlete as a whole. A football player, for example, often uses asymmetrical motor patterns that engage the same lines of force, which can lead to motor preferences and imbalances. Fascia plays a key role as a proprioceptive organ. It is important to retrain movement awareness and interoception (the ability to perceive the internal state of one’s body) to balance both sides of the body.

Conclusion: A holistic approach to performance

In conclusion, flatfoot can be a hindrance to performance, especially if accompanied by pain and dysfunction. However, there is no one-size-fits-all answer. The key lies in a thorough assessment and a holistic approach that combines various techniques. We must think outside the box, explore new methods, and remain open to research.

Feel free to film yourself in motion or make a footprint of your feet after showering to better understand your pressure points. Share your observations on our social media or our Telegram group. We would be delighted to discuss this exciting topic with you.