Pes Planus Test

Orthopedic Exam / Special Tests for Physical Therapy: Feet

Flatfoot (also called pes planus or fallen arches) is a condition in which the longitudinal arch in the foot, which runs lengthwise along the sole of the foot, has not developed normally and is lowered or flattened out. One foot or both feet may be affected. Flat feet  is a postural deformity in which the arches of the foot collapse, with the entire sole of the foot coming into complete or near-complete contact with the ground.
There is a functional relationship between the structure of the arch of the foot and the biomechanics of the lower leg. The arch provides an elastic, springy connection between the forefoot and the hind foot. This association safeguards that a majority of the forces incurred during weight bearing of the foot can be dissipated before the force reaches the long bones of the leg and thigh.


Causes of Pes Planus/ Flat Foot:

Flatfoot may be an inherited condition or may be caused by an injury or condition such as rheumatoid arthritis, stroke, or diabetes.
Children as well as adults may be flat-footed. Most children are flat-footed until they are between the ages of 3 and 5 when their longitudinal arch develops normally.


Signs and Symptoms:

People who have flat feet rarely have symptoms or problems. Some people may have pain because of: Changes in work environment, Minor injury, Sudden weight gain, Excessive standing, walking, jumping, or running, Poorly fitted footwear.


Special Test: Functional or Structural Pes Planus Test

PURPOSE:•To determine whether a pes planus is functional or structural



 Special Test: Functional or Structural Pes Planus PROCEDURE: 

• Therapist observes ( and compares) the orientation of the client’s medial longitudinal arch while doing each of the following:
a. Patient stands straight with both heels and toes on the ground
b. Patient stands with just the toes on the ground
c. Patient sits on the table

Special Test: Functional or Structural Pes Planus POSITIVE TEST:

Functional Pes Planus = if medial longitudinal arch is restored when the client is either standing on the toes or seated = due to muscle or ligament weakness
Structural Pes Planus = if medial longitudinal arch remains flat when the client is standing on toes and when seated.


Treatment in adults generally consists of wearing spacious, comfortable shoes with good arch support. Your doctor may recommend padding for the heel (heel cup) or orthotic shoe devices, which are molded pieces of rubber, leather, metal, plastic, or other synthetic material that are inserted into a shoe. They balance the foot in a neutral position and cushion the foot from excessive pounding.

For children, treatment using corrective shoes or inserts is rarely needed, as the arch usually develops normally by age 5.Surgery is rarely needed. You may be able to relieve heel pain by stretching tight calf muscles.