Flat feet aren't always painful — but when they are, the effects ripple up into the ankles, knees, and hips. Our specialist team designs a plan that addresses your feet and the downstream pain they're causing.
Many people live comfortably with flat feet their entire lives. When pain develops, it usually signals that the arch's supporting structures — tendons, ligaments, or bones — are under more stress than they can manage.
Flat feet (pes planus) occur when the arch of the foot collapses partially or completely, allowing the entire sole to contact the ground. In children, flexible flat feet are common and often resolve naturally — but persistent or painful pediatric flat feet deserve evaluation and early support. In adults, flat feet frequently develop when the posterior tibial tendon — the main tendon supporting the arch — weakens or tears over time.
Flexible flat feet that don't cause pain rarely need treatment. Both pediatric and adult acquired flat feet can progress over time, causing significant arch, ankle, and knee pain if left unaddressed. Early intervention — at any age — prevents the deformity from worsening to the point where surgery becomes necessary.
The most common cause of a gradually flattening arch in adults is dysfunction of the posterior tibial tendon — the main tendon that holds the arch up on the inner side of the foot. This tendon weakens and elongates from overuse, aging, or repetitive strain, allowing the arch to fall progressively. In children, the arch may simply fail to develop fully, or structural factors may prevent normal arch formation.
Obesity increases the load on arch-supporting structures and accelerates tendon strain. Flat feet themselves create abnormal mechanical stress that compounds over time, contributing to further tendon and ligament breakdown. Previous ankle or foot injuries can also damage the tendon or the ligaments that hold the bones of the arch in place. Inflammatory arthritis — especially rheumatoid arthritis — can destroy the joints that maintain arch height.
A clinical examination includes watching you walk (gait analysis) and assessing whether the arch is flexible or rigid. Weight-bearing X-rays measure the degree of collapse and guide the structural treatment plan. In pediatric patients, we also evaluate arch development against age-appropriate norms and determine whether the flat foot is likely to self-resolve or warrants early support to prevent it from persisting into adulthood.
For most patients — children and adults alike — custom orthotics combined with physical therapy provide significant relief and halt progression. In more advanced cases — where the tendon has substantially failed or the bones have shifted — surgical reconstruction restores arch height and long-term function.
We analyze your walking pattern and use standing X-rays to understand how far the arch has collapsed and which structures are most stressed. For children, we assess arch development relative to age to guide intervention timing.
A prescription orthotic insole supports the arch in its correct position — reducing strain on the tendon, relieving pain, and slowing the progression of the deformity.
Targeted strengthening of the calf and tibial muscles improves dynamic arch support, reducing the load on the posterior tibial tendon throughout the day.
For advanced collapse in adults, tendon repair, bone realignment, and ligament reconstruction restore the arch. In pediatric patients with structural flat feet, surgical correction is timed carefully to skeletal maturity for the best lasting outcome.
"I was very satisfied with this office. Dr. O'Bryant is kind, efficient, and has great listening skills. The employees were personable at both the front desk and when getting brought to a back room. I had been to a different podiatrist last and this was a complete change."
"Such a great office! The MA & Dr. O'Bryant were incredible. I brought my daughter in for toenail issues. They were wonderful! I'm recommending this place to everyone! You guys rock! Keep up the amazing job!"
"I loved it from the first visit. The kindness from the staff and from Dr. O'Bryant made all the difference — he heard me out and got me on a clear plan. I finally feel confident about my feet again."
"Very impressed with the care I received. Everything was explained clearly, the office was spotless, and the whole team was professional and friendly from start to finish. Highly recommend The Foot Doc."
