The foot needs to be both flexible as well as rigid during different phases of the walking cycle. The foot in its flexible form is able to accommodate irregular surfaces while maintaining contact with the ground and in its rigid form is able to withstand the stress required while lifting the heel off of the ground when taking the next step forward during propulsion.

People who have flatfeet, visibly noted by a loss of arch height during standing can have a range of complaints consisting of knee pain, shin splints, Achilles tendonitis, and heel pain including plantar fascitis as well as generalized foot discomfort including fatigue with prolonged standing. The term hyper mobile flatfoot suggests that too much flexibility of the foot exists.  The foot motion associated with flatfoot is termed excessive foot pronation.  Excessive foot pronation characterized by the loss of arch height experienced in hyper mobile flatfoot increases the load to the soft tissues including the muscles, ligaments and tendons which contribute to the increase in pain associated with the conditions aforementioned.

An orthotic arch support and shoe is a tool to improve the skeletal position creating more of a rigid foot structure. The orthotic and shoe decrease the abnormal foot pronation experienced in the flat foot deformity by placing the foot in a more supported or neutral position. This neutral foot position is more able to reduce the abnormal loads on the soft tissues associated with lower extremity injury and pain. Evidence based medicine supports the beneficial influence of orthotics on reducing lower extremity complaints associated with the painful flat foot. Orthotics can be commercially purchased at retail outlets or can be custom prescribed by a healthcare provider. Research shows no significant difference in pain scores with people who wear custom versus commercially available non custom foot orthotics.  For someone experiencing lower extremity discomfort associated with the hypermobile flatfoot and excessive foot pronation a firm orthotic and shoe environment is a great tool for helping to relieve the painful symptoms.