Flat Feet & Dropped Arches in Scarborough

Your arch is the messenger, not always the cause

A dropped arch rarely starts at the foot. It's often the last link in a chain that starts higher up — a hip that isn't controlling rotation, an ankle that doesn't bend the way it should, or years of shoes that never asked your foot muscles to do any work. That's why we test how the muscles from your hips down to your toes are actually functioning, not just look at your foot.

How we approach flat feet in Scarborough

• Assess. A full muscle function check, head to toe, to find out what's actually letting the arch drop — not a guess based on the arch alone. Here's what we check at the feet.
• Correct. Daily foot and arch exercises, plus a footwear and orthotics strategy matched to your activity level — the plan below.
• Re-check. We re-test your muscle function, and your orthotics get re-measured by the same person who made them, so the numbers compare. On a 3–6 month schedule set by how consistent you've been.

How your ankle lines up matters too

Look at a flat foot from behind and the ankle often rolls in too — a pattern called hindfoot pronation. It's a well-known sign that travels with a dropped arch, not a separate problem (Physiopedia, overview of pes planus). One quick way we check it: a bank card stood on its edge on the floor, beside the outside of your ankle. Lined up, it touches the side of your foot and your ankle bone at the same time.

It's one of several checks we do at the feet — alongside your toes, big toe, heel, calves and balance. See everything we check in a foot & ankle assessment.

The debate we don't pick a side on

A lot of foot doctors lean hard toward custom orthotics and structured, supportive shoes. Some coaches and minimalist-shoe advocates lean the opposite way. The research says neither extreme wins on its own:

• Orthotics on their own can weaken the very muscles that hold your arch up. In a 12-week study of 18 adults aged 21 to 33 with flat feet, the nine who wore custom orthotics lost 10–17% of the small muscles inside the foot — with no gain in muscle activity to show for it. It’s a small study, and the authors’ own advice is the point: if you wear orthotics, train the foot at the same time (Protopapas & Perry, 2020, Clinical Biomechanics).
• Minimalist footwear rebuilds those same muscles. Eight weeks of walking in minimalist shoes increased foot muscle strength 41% (Ridge et al., 2019, Medicine & Science in Sports & Exercise); six months of daily minimal-footwear use raised it 57% (Curtis et al., 2021, Scientific Reports).
• But rushing into minimalist shoes backfires. Runners who switched over 10 weeks showed more bone stress injury than runners who didn't — the researchers' own advice was to go slower than that (Ridge et al., 2013, Medicine & Science in Sports & Exercise).
• Orthotics aren't useless, either. A systematic review of adult flatfoot studies found real, if modest, evidence they improve standing balance and reduce walking effort (Banwell et al., 2014, Journal of Foot and Ankle Research).

Used alone, both sides of this argument have a documented downside. Used together — the support dialled to how long you are on your feet, paired with daily exercise, brought in gradually — they cover for each other. That's the plan.

Can you graduate out of your orthotics?

Some people do, over time. Not everyone — it depends on which kind of flatfoot you actually have, and that's worth knowing no matter who you see.

Flexible flatfoot — your arch is there when your foot is off the ground, and flattens under weight — is the kind that responds to exercise. In one trial, six weeks of targeted exercise, three sessions a week, improved arch height and alignment significantly more than doing nothing (Brijwasi & Borkar, 2023, Journal of Physiotherapy). That's the mechanism behind reducing — sometimes eventually dropping — how much you rely on an orthotic.

What looks rigid isn't always rigid. A tight calf muscle can hold your foot flat and mimic true rigidity on a quick look. The real test: bend the knee and check the same movement again — if the ankle suddenly moves more freely, a tight calf was the limit, not your bones (FootEducation). That kind of tightness responds to stretching and corrective work over months, the same as a flexible arch does.

Truly rigid flatfoot — where a bone bridge between two foot bones (a tarsal coalition), an extra bone, or a joint that formed differently is genuinely holding things in place — won't change shape through exercise. But that doesn't mean you're done being checked. Your muscles, your weight and your activity level keep changing regardless of what your bones do, which is a real reason on its own to re-evaluate an orthotic over time (reassessment guidance generally recommends at least annual review, more often when your body changes). Nobody here gets a one-time verdict — everyone gets rechecked, and orthotics get adjusted, not fitted once and forgotten.

Your 3-part plan

• Daily corrective exercises. The only part of this that rebuilds arch strength — your foot's own stabilizing "core" muscles (McKeon et al., 2014, British Journal of Sports Medicine).
• Foot-shaped shoes, all day. Wide at the toes, flat from back to front, easy to bend. There is no floor — office, sidewalk or trail — where a narrow, raised-heel shoe is the better pick.
• Your orthotics for the long days. The shifts, the errands, the days that keep you on your feet for hours, while your foot is still building. The trigger is how long you stand and walk, not what is under your feet.

How the orthotics come out

Not by surface. By how long you are on your feet that day, and by what your foot can handle that week.

You earn your way out of the orthotic with the exercises, not with the calendar.

If you sit at a desk all day

You are the easy case, not the hard one. Sitting is not load. Your foot does almost nothing for seven hours, so leaving the orthotic out at your desk costs you very little.

Two catches. The shoe does not do the work. In the studies where feet got stronger, people were walking in those shoes every day. Sit all week and barely move, and changing shoes changes very little. The exercises and the steps are what build the foot.

And watch Saturday. Sitting all week, then a 15,000-step day in your least supportive shoes, is how people get hurt. Spread the walking across the week instead of saving it all for one day.

At home, and if you work from home

Same rule at home: it's about how long you're on your feet, not the floor.

• Short trips around the house: barefoot is fine, at any step.
• Chores that run longer than your step allows — cooking, cleaning — wear an indoor pair of foot-shaped shoes with the orthotic in. Xero works, or Vivobarefoot with their insole taken out. Keep that pair for indoors. FiveFingers won't work here: no orthotic fits in them.
• As your step goes up, so does your time barefoot at home.
• Toe shoes for around the house, like Peluva's slip-on Zen or Vibram FiveFingers. Your toes stay spread and your foot does the work, with a bit of padding on hard floors. No orthotic fits in them, so they count as orthotic-out time: stick to what your step allows. Toes don't fit the pockets? Barefoot or a wide indoor shoe works too. Doctor said no minimalist shoes? Ask before you use these.
• Skip floppy, backless slippers. They change how you step.
• Optional extras: toe spacers for a few minutes at a time, barefoot or in wide shoes, and toe socks (like Injinji) so your toes aren't squeezed together. Nice to have, not the treatment — in one small trial, adding a spacer to foot exercises did no better than the exercises alone (Meh et al., 2026). Skip spacers if you have numbness or diabetes.
• Working from home? Orthotic out at your desk from day one, the same as in an office. Your bigger risk is moving too little, so don't skip the daily walk.

Your exact steps, and when we re-check your orthotics, get set at your assessment and adjusted from there — based on how much time you spend on your feet and how consistent you are with the exercises, not a generic timeline.

Don't go back to your old shoes

People do the exercises, buy the flexible shoes for the trail — then put the old work shoes back on for the other ten hours of the day. Two things about those shoes matter: the shape of the front, and the height of the back.

A pointed front reshapes your foot. Bunions, hammer toes, corns and ingrown nails all trace back to shoes that press the toes together. The advice from the American Academy of Orthopaedic Surgeons: pick a shoe shaped like your foot, rather than letting your foot take the shape of the shoe (OrthoInfo, AAOS).

A raised heel is not just a women's problem. Dress shoes, work boots and most running shoes are built higher at the back than the front — 7 mm or more is normal in a runner, and a dress shoe is often double that. Stand on that slope all day and two things follow that have actually been measured: calves adapt short (regular heel wearers had shorter calf muscle fibres, stiffer Achilles tendons and less ankle movement — Csapo et al., 2010), and knees take more load (across 14 studies, walking in heels raised knee bending and side-to-side load at the knee — Nguyen et al., 2021). Your ankle has to bend for your arch to work, and your knee pays when it can't.

You'll also hear that heels tip your pelvis forward. When that was measured in experienced wearers, the low-back curve didn't change and the pelvis tipped slightly the other way (Schroeder & Hollander, 2018) — so I stick to the parts that hold up: the calf and the knee.

What I see in the clinic. Once your feet are working again and your body is moving the way it should, putting it back into a restrictive shoe tends to show up somewhere — the foot, the knee, the hip or the back. That part is my own experience rather than a study. Either way, there's no sense undoing six weeks of work for eight hours a day.

The shoes I use myself

• Vivobarefoot — my everyday shoe: wide at the toes, flat and flexible, but it still looks like a normal shoe. Work, errands, long days on my feet, and boots for wet weather.
• Xero Shoes — sandals and light trainers. Warm weather, the gym, travel, grass and easy trails. Easiest of the three to drop an insole into.
• Vibram FiveFingers — the most ground feel, with a pocket for each toe. Foot work, the gym, grass, sand and short walks on uneven ground. Build up to these slowest.

Shoes I buy and wear myself, not a sponsored list. The shape matters more than the brand: wide at the toes, flat from heel to toe, and bendy.

Long days on hard pavement: I also recommend Altra running or walking shoes. Wide at the toes like the others, with more cushion underfoot, and their insole comes out so your orthotic can go in (their FAQ). Check that the heel drop says 0 mm before you buy — some newer Altra lines, like the Experience series, have a small drop.

Your orthotics still fit in them

You don't have to choose between your orthotics and better shoes while you're building strength. Vivobarefoot says take their insole out for a full orthotic, leave it in for a half or quarter one, and follow your doctor (their guidance). Xero's flat, no-arch soles make them easy to add an insole to (their FAQ). FiveFingers are the exception — glove fit, toe pockets, no room for an orthotic — so keep those for the exercise end of your plan. The plan itself doesn't change: foot-shaped shoes all day, the orthotic in for the long days, and a re-check on the schedule below.

Three fit checks when your orthotic goes into one of these shoes: take the shoe's own insole out first, go up half a size if it feels tight, and make sure your heel doesn't slip — these shoes have soft heels, so a loose orthotic can shift. One honest trade-off: with the orthotic in, you keep the toe room, but your foot does less of the work. That's why the plan builds up time without it. No study has tested custom orthotics in these exact shoes yet; in one study of healthy adults, adding a supportive insole to a minimal shoe didn't change how they walked (Haowlader et al., 2025).

How soon we re-check, based on your consistency

Why re-check? As your foot gets stronger, it can change. An orthotic made for your old foot may not fit your new one. At the re-check we test your feet again, then decide together: keep the orthotic, use it less, or go back to the person who made it to have it changed. Go back to the same person each time. Different examiners measure the same foot a little differently, so the same person is the fairest way to see what really changed (McPoil et al., 2009).

The honest 3–6 month range mentioned above isn't arbitrary — here's roughly how it breaks down. Count the days you ticked on your tick sheet.

Common questions