The Role of Electrical Stimulation and Exercise in Managing Flexible Flatfoot: A Narrative Review

Document Type : Review Article

Authors

1 Assistant professor of physical therapy at Deraya University

2 Professor of Physical Therapy, Basic Science Department, Faculty of Physical Therapy,

3 Lecturer of Orthopedic Faculty of medicine Assiut University

4 Instructor

Abstract

Flexible flatfoot, or pes planus, is a common postural deformity characterized by the collapse of the medial longitudinal arch during weight-bearing, which may lead to discomfort and altered biomechanics. It frequently presents in children and may persist into adulthood, potentially causing pain, fatigue, and gait abnormalities. Conservative management is typically the first line of treatment, with physical therapy playing a pivotal role. This narrative review explores two primary conservative interventions—exercise and electrical stimulation and their combined role in managing flexible flatfoot.
Exercise-based interventions focus on strengthening the intrinsic and extrinsic muscles of the foot, particularly those involved in supporting the arch, such as the tibialis posterior. Targeted activities, including foot doming, toe curls, balance training, and stretching, have demonstrated effectiveness in improving dynamic stability and proprioception. These exercises not only enhance foot strength but also improve motor control and functional performance. On the other hand, electrical stimulation techniques especially neuromuscular electrical stimulation (NMES) and transcutaneous electrical nerve stimulation (TENS) offer adjunctive benefits by promoting muscle activation and modulating pain. NMES is particularly effective in eliciting controlled muscle contractions, which may further reinforce the arch and complement exercise outcomes. The integration of these two modalities offers a holistic, non-invasive treatment approach. By combining the benefits of both techniques, clinicians can optimize therapeutic outcomes and address the multifaceted nature of flexible flatfoot. This review consolidates current knowledge and highlights the synergistic potential of electrical stimulation and exercise as complementary strategies for effective flatfoot management.

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