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Flat feet: deformities or healthy anatomical variants?
  1. Gabriel Moisan1,
  2. Ian Griffiths2,
  3. Dominic Chicoine1
  1. 1 Human Kinetics, Université du Québec à Trois-Rivières, Trois-Rivieres, Quebec, Canada
  2. 2 Sports and Exercise Medicine, Queen Mary University of London, London, UK
  1. Correspondence to Dr Gabriel Moisan, Human kinetics, Université du Québec à Trois-Rivières, Trois-Rivieres, Quebec G9A 5H7, Canada; gabriel.moisan{at}

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Historical review

For many years, researchers and clinicians believed that individuals with flat feet were at high risk of sustaining a musculoskeletal injury during sports and activities of daily living. Even though this theory was postulated a long time ago, it was revived during the second half of the 20th century when Root et al 1 popularised the concept of ‘ideal feet’. According to those authors, feet that did not fit specific criteria for normalcy were considered abnormal, less efficient and more prone to injury due to many biomechanical compensations. This paradigm became the cornerstone of educational curriculums in health profession education related to the human musculoskeletal system. Consequently, throughout the years and persisting to this day, many healthcare professionals and researchers have perpetuated the belief that flat feet are an important risk factor for musculoskeletal disorders, creating a perceived need for treatment even if no symptoms are present.

Flat feet and musculoskeletal injuries

In contrast to the theory of Root et al,1 two meta-analyses found a weak causal link between flat …

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  • Contributors GM, IG and DC drafted the manuscript, edited and reviewed the final version.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.