No trial shows Pilates changes the arch
No trial has tested whether Pilates changes the arch or eases flat-foot pain. Two small trials found better walking or balance in people with flat feet, with clear limits, and neither reported an arch change.
Pilates guide
Pilates for flat feet: flexible and rigid flat feet, the arch muscles, footwork, what the evidence shows, and a 25-minute class
No trial shows that Pilates changes the arch or eases flat-foot pain. Most flat feet, or fallen arches, are normal and need nothing doing: the NHS says they usually cause no problems and shouldn't stop you doing sport. If your feet ache or tire, foot exercises and strength for your hips and legs can help with comfort, though no exercise has been shown to rebuild an arch. Pilates fits as the hip, leg and balance part.
A flat foot that is new, painful, stiff or on one side only is different: check the warning signs below first. Pilates sits beside the care of a GP or podiatrist, never in place of it.
This guide covers flexible and rigid flat feet, children's feet, the arch muscles and the tibialis posterior tendon, what foot exercises and the small Pilates studies show, reformer footwork, bare feet and shoes, the warning signs including diabetes, and a 25-minute class for the arches, ankles, hips and balance.
17 moves17 with 3D demosFlexible or rigid?What the evidence saysFootwork and shoesMovesThe classWarning signs
The short version
Most flat feet are normal
The NHS says flat feet usually cause no problems, "should not stop you doing any activities, including sports", and need nothing doing if they aren't causing problems. Podiatrists say "the height of the arch does not have any bearing on how well a foot can function".
Foot exercises change arch measures a little
The short foot exercise moved arch measures by fractions of a millimetre in 6 trials, and a 2024 review found no clear effect. The NHS says exercises and insoles "will not change the shape of your feet but can help with things like pain or stiffness".
Add the hips and legs: that's where Pilates fits
Programmes that trained the hips and whole leg as well as the feet did a little better on arch measures, at low certainty. Pilates is a good way to do the hip and leg part.
A painful, dropping arch is different
A new, painful or one-sided flat foot in an adult is often the tibialis posterior tendon. Orthoses with slow strengthening for that tendon did best in a small trial. Check the warning signs below first.
Know the warning signs
See a GP for "Flat feet that are painful, stiff, weak or numb, that you didn't have before, or that affect only one foot". With diabetes, "Any foot pain if you have diabetes: foot problems can be more serious." The full list is below.
Flat feet, and where Pilates fits
Usually nothing to worry about
The NHS describes flat feet, or fallen arches, as feet that "press flat on the ground", and says "They're common and usually nothing to worry about". Sometimes there's pain around the ankle or lower leg, the arch aches, or shoes wear out quickly. There's often no obvious cause, and flat feet sometimes run in families.
Source 4
Flexible or rigidStrong evidence
A flexible flat foot looks flat when you stand, but its arch comes back when you sit, stand on tiptoe or bend your big toe up; a rigid one stays flat either way. Children's orthopaedic surgeons say the arch reappearing on tiptoe "differentiates between flexible and stiff flatfeet". A rigid, painful flat foot in a teenager is often two foot bones joined together (a tarsal coalition), which our tarsal coalition guide covers.
ChildrenStrong evidence
In 835 children aged 3 to 6, 44% had flexible flat feet, falling from 54% at age 3 to 24% at age 6. The NHS says arches usually develop between 3 and 10. Children's orthopaedic surgeons: "The pain-free flexible flatfoot needs reassurance and NOT referral or treatment".
Adults, and the tibialis posterior tendonEmerging evidence
The tibialis posterior is the deep calf muscle whose tendon runs behind the inner ankle bone into the arch. When the tendon fails, the arch drops, often on one side. US surgeons now call this progressive collapsing foot deformity (it used to be called adult acquired flatfoot); it's more common in women and over 40. In one English practice, 3.3% of women over 40 had symptoms, none of them diagnosed. Our posterior tibial tendinopathy guide covers it.
Do flat feet cause pain?Emerging evidence
Weakly, if at all. In 21 cohorts (6,228 people), a flat (pronated) foot was a small risk factor for shin splints, and not for foot, ankle or general overuse injuries. In 927 novice runners in neutral shoes, flatter feet weren't at higher risk, and in army trainees the flattest feet had the lowest injury risk. In older adults, the flattest feet went with slightly higher odds of knee and arch pain, in studies that can't show cause, and foot posture wasn't linked with low back pain.
What Pilates asks of your feet
Mat Pilates is mostly lying and side-lying, so your feet do little except in standing and wall work. Reformer footwork presses the carriage away with your feet on the footbar: a lying calf raise against springs. The force on the footbar has been measured in one volunteer only, and no study has measured what footwork does to the arch. Joseph Pilates also designed a "Foot Corrector"; no study has tested it.
Where Pilates fits
As the hip, leg and balance work that reviews suggest adding to foot exercises, with the short foot exercise, heel raises and band work for the inside of the ankle added to the class. It won't change the shape of your feet, and a painless flat foot needs no programme at all.
Check: flexible or rigid?
The tiptoe check children's orthopaedic surgeons and podiatrists describe, in our words. It isn't a diagnosis.
- Stand barefoot with your feet hip-width apart, and look at the inside of each foot: is there a gap under the arch?
- Rise slowly onto tiptoe, holding a wall or counter.
- If an arch appears as your heels lift, your flat feet are flexible: a normal variation.
- If a foot stays flat on tiptoe, it may be rigid: check the warning signs below.
See the movement on the 3D figure: Slow calf raise
What the evidence says
Foot exercises change arch measures a littleMixed evidence
In 6 trials (201 people), the short foot exercise reduced the drop of the arch (navicular drop) by 0.23 mm and improved a foot posture score by 0.67 points, with no change in muscle size. A 2024 review found no significant difference from control overall, and effects appeared after about 5 to 8 weeks. Across 13 trials, training the small foot muscles improved arch measures, balance and strength, but not pain.
Hip and whole-leg work helps a little moreEmerging evidence
In a network meta-analysis of 11 trials in adults with flexible flat feet, strengthening the tibialis posterior with hip stretching and core exercise ranked best, and the authors highlight "hip muscle and lower limb overall muscle training". A 2026 review of 14 trials found programmes with hip or whole-leg work lowered navicular drop by about 2.3 mm, at low certainty, with too little evidence on pain.
Two small Pilates trials, with clear limitsMixed evidence
In 22 women with flexible flat feet, 8 weeks of mat Pilates twice a week improved walking rhythm and side-to-side sway against no exercise. But the same researcher ran the classes and did the measuring, the trial was registered only after it had run, and the arch was measured only at the start.
In 44 students, adding Pilates twice a week to daily short foot exercise for 5 weeks improved a balance score and foot function more than the foot exercise alone. But the Pilates was added on top of the foot exercise, so that group exercised for longer, and no arch result was reported.
Pilates on its own: no change in balance or children's archesEmerging evidence
In 91 young women, 16 weeks of Pilates "did not improve postural control and proprioception in individuals with flatfeet", and the authors advise combining Pilates with other exercise. In 40 school children, mat Pilates twice a week didn't change balance or the arch. No trial has tested whether Pilates eases flat-foot pain.
For a painful tendon: strengthening with orthosesEmerging evidence
In 36 adults with early tibialis posterior tendon problems, everyone wore orthoses and stretched for 12 weeks; adding resisted exercise helped, and slow lowering helped most. A review of the 3 tendon trials (93 people) found moderate effects for this combination and warned that calf stretches at full ankle bend "may be counterproductive" for the tendon. Arch-supporting orthoses may ease early pain, in trials at high risk of bias.
Children: insoles don't build archesStrong evidence
In healthy children with painless flat feet, orthoses made little or no difference to pain at a year (a Cochrane review of 16 trials and 1,058 children, very low to low certainty), and they didn't change the arch in the long term. No exercise trial in children has measured pain.
Footwork, standing work and shoes
Reformer footwork
Fine for most people. Keep your ankles in line, don't let your arches collapse onto the bar, and use lighter springs with a sore inner ankle (our suggestion; the force on the footbar has been measured in one volunteer only).
Source 26
Bare feet, grip socks or shoes
Barefoot or grip socks are fine on a mat for most people. If standing work hurts, supportive shoes are kinder: for painful flat feet, the NHS says "wide, comfortable shoes with a low heel are usually best". Grip socks stop slipping; they don't support the arch (our suggestion).
Source 4
With diabetes or numb feet
With numb feet or diabetes, do standing work and footwork in shoes and check your feet before and after (our suggestion; our Pilates for diabetes guide covers foot care).
Source 12
The short foot exercise (no 3D demo yet)
From the short foot and toe splay move's page, in our words; the 10 holds of 5 seconds are from our foot and ankle routine. It has no 3D demo yet, so it isn't in the moves grids or the class: add it on other days.
- Sit with one bare foot flat on the floor, your weight on the big-toe knuckle, the little-toe knuckle and the heel.
- Without curling your toes, draw the big-toe knuckle gently towards your heel so the arch lifts.
- Hold for 5 seconds, then relax. Do it 10 times.
- Then spread all your toes as wide as they go, hold, and set them down.
- Keep your toes long and soft, and don't roll the foot outwards to fake an arch.
- When it's easy sitting, do it standing, then on one leg.
Feet and ankles, sitting
Barefoot or in thin socks. Towel scrunch, 2 sets of 12 each foot (our foot and ankle routine); ankle circles, 10 slow circles each way with each foot (the move's page); band inversion, sweeping the foot in against a band, 8 each side (our foot and ankle routine), or "For tibialis posterior tendon pain, 3 sets of 15 at a resistance you can only just complete, twice a day for 12 weeks, with a slow return" (the move's page); seated bent-knee calf raise, 3 sets of 15 (our flat feet guide's plan).
Standing: heel raises and balance
Next to a wall or counter. Slow calf raise, rising through the big toe so your ankles don't roll out: 2 sets of 10, building to 3 sets of 30 (the Houck 2015 trial's progression, as our flat feet guide gives it). Single-leg calf raise from a step, starting on flat ground: 2 to 3 sets of 10 each leg, building (our flat feet guide). Single-leg stand, 2 holds of 30 seconds each leg, and tandem stance then heel-to-toe walk, 30 seconds, then 10 steps (our foot and ankle routine). Single-leg reach: 3 rounds of 5 reaches in each direction, each leg (the move's page).
Pilates for the hips and legs
Press through the whole foot, big toe down, in the bridges, and point then flex your foot at the top of each leg circle (our suggestion). Clamshell, 2 to 3 sets of 12 each side (our flat feet guide). From the moves' pages: side kick, 8 to 10 each side; wall side leg lift, 10 to 12 each side; shoulder bridge, 3 to 5 kicks each leg; wall bridge, 8 to 10 reps; single-leg circle, 5 circles each direction, each leg.
3D demoClamshellBeginner · No equipment
3D demoSide kick (Pilates side kick series)Beginner · No equipment
3D demoWall side leg lift (standing side kick at the wall)Beginner · A wall
3D demoShoulder bridge (Pilates)Intermediate · No equipment
3D demoWall bridge (feet-on-wall bridge)Beginner · A wall
3D demoSingle-leg circle (Pilates one leg circle)Beginner · No equipmentCalf stretches, gentle and optional
Knee straight, then knee bent: 3 holds of 30 seconds each side, twice a day (our Pilates for plantar fasciitis guide). Keep them gentle with a sore inner ankle: a review of the tendon trials warns that calf stretches at full ankle bend may work against the tendon.
What to change or leave out
Our suggestions, agreeing with our flat feet and Pilates for plantar fasciitis guides.
Hard inner-ankle and calf stretches with a sore tendon
The posterior tibialis stretch's own caution: "With pain along the inner ankle (the tibialis posterior tendon), don't force this stretch; the trials strengthened that tendon rather than stretching it."
Source 33
Jumping during a painful flare
Leave out the jumpboard and jumping, and keep standing blocks short, while your feet hurt. Our flat feet guide notes "Arthritis UK says the pain gets worse with activity, particularly running and jumping."
Toe stretches
Kneel with your toes tucked under only if it's comfortable, and skip it with bunions, big toe arthritis or pain under the ball of your foot.
Hypermobile joints
Keep foot and ankle work in the middle of the range rather than pushing to the end (our suggestion, from our Pilates for hypermobility guide).
Children's flat feet
Reassurance, not treatment
Most young children have flat feet, and arches usually develop between 3 and 10. A painless flexible flat foot needs no exercise programme, insoles or referral, and orthoses don't change how the arch develops. Pilates is fine as exercise if your child enjoys it; our Pilates for kids guide has a class.
When to see a GP
See a GP if your child's flat foot is painful, stiff or rigid, affects only one foot or looks very different from the other, is new, or stays flat when they stand on tiptoe; or if they often sprain an ankle, have problems with walking or balance, or struggle to keep up with activities because of their feet.
A painful, dropping arch
Get it checked, then load the tendon
A flat foot that is new, painful or on one side only in an adult is often the tibialis posterior tendon. Check the warning signs below first. Our flat feet guide then has a 12-week plan built on the tendon trials, in which band inversion builds to 3 sets of 15 at a resistance you can only just complete, twice a day. Gentle Pilates for your hips and the rest of you can carry on alongside, with the calf stretches kept gentle.
Classes
Our class does seated foot work first, then standing heel raises and balance, then Pilates for the hips; its order and doses are editorial. The foot and ankle routine is the closest class without Pilates. With heel pain, use the Pilates for plantar fasciitis class instead.
Feet-first Pilates for flat feet: a 25-minute class for the arches, ankles, hips and balance
A 25-minute Pilates class for flat feet: seated foot and ankle work, standing heel raises and balance, then Pilates for the hips and a gentle calf stretch.
25 minBeginner14 movesOther / check instructions, A bench or box
Foot and ankle strengthening routine: toes, arches, calves and balance
A 15-minute barefoot routine for stronger toes, arches, calves and ankles, finishing with balance. You need only a towel, a wall and a resistance band.
15 minBeginner11 movesA wall, Other / check instructions
Mid-range Pilates for dancers: a 25-minute mat class for feet, turnout control and trunk
A 25-minute Pilates class for dancers: feet and calves, turnout control from the hip, trunk endurance and back extension, all in the middle of your range.
25 minBeginner17 movesOther / check instructions, A bench or box
Standing Pilates for balance: a 25-minute counter and mat class
A 25-minute Pilates class for steadier balance: standing balance and leg strength at a kitchen counter, then mat work for your trunk and hips.
25 minBeginner17 movesA wall, A bench or box
Pilates for plantar fasciitis: a 25-minute class that starts sitting, keeps you off your feet, and ends with heel raises
A 25-minute Pilates class for heel pain: sole and calf stretches before you stand, mat Pilates lying down, heel raises every second day, and short standing work.
25 minBeginner15 movesA bench or box, Other / check instructionsWarning signs: when to get help
These are the same warning signs as our flat feet and foot pain guides, word for word. This is general information, not a diagnosis. A&E means accident and emergency; in the US, call 911 for 999, and use your doctor's urgent line or urgent care for NHS 111.
Call 999 or go to A&E
- Call 999 or go to A&E: you have diabetes and a foot ulcer with a fever or signs of sepsis, an ulcer with poor circulation, a possible deep infection of the soft tissues or bone in the foot (with or without an ulcer), or gangrene. NICE asks for these to go straight to hospital.
- Call 999 or go to A&E: after an injury, you heard a crack, the foot or ankle has changed shape or points at an odd angle, a bone is sticking out, there is a bad cut over it, you're in severe pain, or the toes look blue or white, feel numb or are cold to touch. These can mean a broken bone. Don't drive yourself.
Source 12
Get help the same day
- Same day: you have diabetes and a new foot problem, such as an ulcer or wound, signs of infection, or a hot, swollen foot with a change in colour, even if it doesn't hurt. Contact your diabetes foot team or GP: NICE asks for these to reach a specialist foot service within 1 working day, and a suspected Charcot foot is kept off weight until it has been checked.
- Same day: a sudden pop on the inside of the ankle followed by a change in the shape of the foot. The tendon may have torn (our suggestion).
- Same day: a sudden, very painful, hot, swollen, red joint, often the big toe but sometimes the middle of the foot (the midfoot) or the ankle, especially with a high temperature, feeling shivery or being unable to eat. It may be gout, but it could be a joint infection (septic arthritis), which is urgent.
Source 12
See a GP
- Flat feet that are painful, stiff, weak or numb, that you didn't have before, or that affect only one foot, or flat feet and you often get foot or ankle injuries or have problems with walking or balance.
- You can't do a single-leg heel raise on the painful side, or the foot is visibly flattening.
- Pain on the outside of the ankle as well as the inside, which can mean the foot shape is changing.
- Not improving after about 6 weeks of insoles and exercise (our suggestion).
- Tingling or loss of feeling in the foot, or a foot that feels weak.
- Any foot pain if you have diabetes: foot problems can be more serious.
Source 4
A child's flat foot
- See a GP if your child's flat foot is painful, stiff or rigid, affects only one foot or looks very different from the other, is new, or stays flat when they stand on tiptoe; or if they often sprain an ankle, have problems with walking or balance, or struggle to keep up with activities because of their feet.
- A flat foot whose arch doesn't come back when your child stands on tiptoe, a flat foot on one side only, or a flat foot with a tight calf: see a GP. Children's orthopaedic surgeons call a one-sided flat foot a red flag that needs further assessment.
Source 13
A high arch is a different sign
A high arch that is new, getting higher or only in one foot, or high arches with weakness, tripping, numbness or ankles that keep giving way: see a GP. It can be the first sign of a nerve condition.
Chest pain or fainting while exercising: call 999
Call 999 if:
- You get sudden pain or discomfort in your chest that doesn't go away; it can feel like squeezing or pressure, burning or indigestion.
- The pain spreads to your left or right arm, or your neck, jaw, stomach or back.
- You have chest pain and feel sweaty, sick, light-headed or short of breath.
- Someone faints while exercising, can't be woken within 1 minute, or has chest pain or a pounding, fluttering or irregular heartbeat.
Unusual breathlessness
Call 999 or go to A&E (accident and emergency) straight away for severe difficulty breathing (gasping, choking or not able to get words out), a chest that feels tight or heavy, pain that spreads to your arms, back, neck and jaw, lips or skin turning very pale, blue or grey, or sudden confusion. If you're more short of breath than usual, or your heart is racing, fluttering or skipping beats, contact NHS 111.
Stop the session if
You feel any pain or become unwell, as the NHS advises for its Pilates videos, and especially for chest pain or pressure, unusual breathlessness, dizziness or fainting. If you have a health problem, an injury or any symptoms, get advice from a healthcare professional, such as a GP, before you start.
Source 40
Before you start
The NHS advises getting advice from a healthcare professional first if you have a health problem, an injury or symptoms, or have recently had a heart attack or an operation.
Source 40
Myths
"Flat feet must be fixed"Strong evidence
Most flat feet cause no problems and need no treatment, and children's orthopaedic surgeons say "The pain-free flexible flatfoot needs reassurance and NOT referral or treatment".
"Pilates will rebuild your arches"Strong evidence
Short foot exercise moved arch measures by fractions of a millimetre on average, one review found no significant effect, and no Pilates trial has shown an arch change. Exercises "will not change the shape of your feet but can help with things like pain or stiffness", the NHS says.
"Flat feet cause knee and back pain"Emerging evidence
Studies in older adults found small links with knee and arch pain that can't show cause, and none with back pain; cohorts found no general injury risk beyond a small one for shin splints.
"Children need insoles so their arches develop"Strong evidence
Arches usually develop by themselves between 3 and 10, and orthoses don't change how the arch develops.
"Walk barefoot to fix flat feet"Mixed evidence
We found no trial of barefoot walking or minimalist shoes in flat feet. In general, foot exercises and minimalist shoes build foot strength, at low certainty. With diabetes or numb feet, don't go barefoot for standing work.
Source 41
"You need a reformer for footwork"Strong evidence
Heel raises, towel curls and the short foot on a mat or standing do the same jobs, and no study has measured what reformer footwork does to the arch.
Read next
- Flat feet
- Posterior tibial tendinopathy
- Foot pain in children
- Tarsal coalition
- Yoga for feet
- Fascia release for the feet
- How to strengthen your feet
- Pilates for plantar fasciitis
- Pilates for diabetes
- Pilates for dancers
- Pilates for balance
- Pilates for kids
- The tibialis posterior
- The abductor hallucis
- Foot and ankle exercises
- The Pilates guide
Questions people ask
Is Pilates good for flat feet?
It can be part of the exercise that suits achy or tired flat feet, but no trial has shown it changes the arch. Its strengths are the hips, legs and balance, which reviews suggest adding to foot exercises. Add the short foot exercise, heel raises and band work for the inside of the ankle to your class.
Can Pilates fix flat feet?
No exercise reliably reshapes a foot: short foot exercise changed arch measures by fractions of a millimetre on average, and the NHS says exercises and insoles "will not change the shape of your feet but can help with things like pain or stiffness". Most flat feet don't need fixing at all.
What are the best Pilates exercises for flat feet?
Towel curls and the short foot exercise sitting down, band work for the inside of the ankle, slow heel raises keeping your ankles from rolling out, single-leg balance, and Pilates hip work (side kicks, clamshells and bridges). Our 25-minute class puts them in order.
Is reformer Pilates good for flat feet?
Footwork is a lying calf raise against springs, and it's fine for most people: keep your ankles in line and don't let your arches collapse onto the bar. No study has measured what it does to the arch. With a sore inner ankle, use lighter springs (our suggestion).
Should I do Pilates barefoot, in grip socks or in shoes with flat feet?
Barefoot or grip socks are fine on a mat for most people, and if standing work hurts, supportive shoes are kinder. "With numb feet or diabetes, do standing work and footwork in shoes and check your feet before and after (our suggestion; our Pilates for diabetes guide covers foot care)." Grip socks stop slipping; they don't support the arch.
Are my flat feet flexible or rigid?
Stand on tiptoe: if your arch appears, they're flexible, which is a normal variation. If a foot stays flat on tiptoe, or is stiff or painful, get it checked: see a GP for "Flat feet that are painful, stiff, weak or numb, that you didn't have before, or that affect only one foot, or flat feet and you often get foot or ankle injuries or have problems with walking or balance."
Do flat feet cause knee or back pain?
Not as a rule. A review of 21 cohorts found a flat foot was a small risk factor for shin splints only, and in older adults the flattest feet went with slightly more knee pain but no more back pain, in studies that can't show cause.
My child has flat feet. Should they do Pilates or foot exercises?
Only if they enjoy it: most children develop arches between 3 and 10, and a painless flexible flat foot needs reassurance, not treatment. "See a GP if your child's flat foot is painful, stiff or rigid, affects only one foot or looks very different from the other, is new, or stays flat when they stand on tiptoe; or if they often sprain an ankle, have problems with walking or balance, or struggle to keep up with activities because of their feet."
One of my arches is dropping and the inside of my ankle hurts. Is Pilates OK?
Get it checked first: in adults this is often the tibialis posterior tendon. See a GP if "You can't do a single-leg heel raise on the painful side, or the foot is visibly flattening." Strength work for that tendon with orthoses helped most in trials; our flat feet guide has the plan, and gentle Pilates can carry on alongside.
How long do flat feet exercises take to work?
Arch measures changed after about 5 to 8 weeks in trials, and the tendon trials ran for 12 weeks. Do the foot work most days and Pilates 2 to 3 times a week (our suggestion), and expect comfort and strength rather than a new arch shape.
Do I need insoles as well?
Only if your flat feet hurt or cause problems, the NHS says. For early tendon pain, arch-supporting orthoses may ease pain, especially with exercise; in healthy children with painless flat feet, they made little or no difference.
Is it safe to do Pilates with flat feet and diabetes?
Yes, with care for your feet: do standing work in shoes, check your feet before and after, and see our Pilates for diabetes guide. "Same day: you have diabetes and a new foot problem, such as an ulcer or wound, signs of infection, or a hot, swollen foot with a change in colour, even if it doesn't hurt."
Sources
- PubMed, Europe PMC and ClinicalTrials.gov · Our searches for studies of Pilates in flat feet (October 2026)
- Kim 2026 · Mat Pilates for walking and balance in 22 women with flexible flat feet (pilot randomised trial, Int Biomech; read in full)
- Ali 2025 · Pilates added to short foot exercise in 44 students with flat feet (randomised trial, Advances in Rehabilitation; read in full)
- NHS · Flat feet
- Royal College of Podiatry · Flat foot management (read in full)
- Huang 2022 · The short foot exercise in flat feet: 6 trials, 201 people (meta-analysis, Int J Environ Res Public Health; read in full)
- Cheng 2024 · Short foot training and foot posture in flat feet (systematic review and meta-analysis, J Back Musculoskelet Rehabil)
- Jia 2024 · Exercise for adults with flexible flat feet: 11 trials (network meta-analysis, Sci Rep)
- Xiong 2026 · Adding hip and whole-leg work to exercise for flexible flat feet: 14 trials (systematic review and meta-analysis, Front Physiol)
- OrthoInfo · Progressive collapsing foot deformity, or adult flatfoot (American Academy of Orthopaedic Surgeons patient information; read in full)
- Kulig 2009 · Orthoses and resisted exercise for tibialis posterior tendon problems in 36 adults (randomised trial, Phys Ther)
- NICE NG19 · Diabetic foot problems: prevention and management
- British Society for Children's Orthopaedic Surgery · Management of flexible flatfeet in children (consensus statements; read in full)
- Benedetti 2011 · Diagnosing flexible flat feet in children (clinical study, Orthopedics)
- Soni 2020 · Tarsal coalition (review, Curr Opin Pediatr)
- Pfeiffer 2006 · Flat feet in 835 children aged 3 to 6 (cross-sectional study, Pediatrics)
- Staheli 1987 · The arch in 882 feet of children and adults (survey, J Bone Joint Surg Am)
- Myerson 2020 · Progressive collapsing foot deformity: a new name for adult flatfoot (expert consensus, Foot Ankle Int)
- Kohls-Gatzoulis 2009 · Tibialis posterior tendon problems in women over 40 in England (prevalence study, Foot Ankle Surg)
- Neal 2014 · Foot posture and overuse injury: 21 cohorts, 6,228 people (systematic review and meta-analysis, J Foot Ankle Res)
- Nielsen 2014 · Foot pronation and injury in 927 novice runners (cohort study, Br J Sports Med)
- Cowan 1993 · Foot shape and injury in army trainees (cohort study, Arch Fam Med)
- Gross 2011 · Flat feet and knee pain in older adults (cross-sectional study, Arthritis Care Res)
- Menz 2013 · Flat feet and foot pain: the Framingham foot study (cross-sectional study, Arthritis Care Res)
- Menz 2013 · Foot posture and low back pain: the Framingham foot study (cross-sectional study, Rheumatology)
- Brodt 2014 · Measuring the force on a Pilates footbar, in one volunteer (lab study, J Appl Biomech)
- Pilates Method Alliance · History of Pilates (read in full)
- Hara 2023 · Short foot exercises for flat feet (systematic review, J Back Musculoskelet Rehabil)
- Jaffri 2023 · Training the small foot muscles: 13 trials (systematic review and meta-analysis, J Athl Train)
- Ghorbani 2026 · Pilates, balance and joint sense in 91 women with and without flat feet (trial, Foot Ankle Spec)
- Neves 2021 · Mat Pilates, balance and the arch in 40 school children (randomised trial, J Bodyw Mov Ther)
- Houck 2015 · Orthoses with stretching, or stretching and strengthening, for tibialis posterior tendon problems in 39 adults (randomised trial, Foot Ankle Int)
- Ross 2018 · Exercise for tibialis posterior tendon problems: 3 trials, 93 people (systematic review, BMJ Open Sport Exerc Med; read in full)
- Gómez-Jurado 2021 · Orthoses for early tibialis posterior tendon problems: 4 trials (systematic review, Clin Rehabil)
- Evans 2022 · Foot orthoses for children's flat feet: 16 trials, 1,058 children (Cochrane review; read in full)
- Choi 2020 · The long-term effect of orthoses on children's flexible flat feet (systematic review, Foot Ankle Surg)
- Lin 2026 · Non-surgical treatments for children's flexible flat feet: 11 trials, 761 children (network meta-analysis, Phys Ther)
- NHS · Heart attack
- NHS · Chest pain (past its review date: reviewed August 2023, review due August 2026)
- NHS · Pilates for beginners
- Peters-Dickie 2025 · Foot exercises and minimalist shoes (systematic review and meta-analysis, Clin Biomech)
Exercise education, not a personal prescription, and clinical review of these guides is pending. If you are pregnant, have a health condition or have had recent surgery, check with a doctor, midwife or physiotherapist before starting, and stop for sharp or increasing pain. Health disclaimer.