Flat Feet

What Are Flat Feet?

The condition of flat feet is a podiatric disorder characterized by little to no visible arch on the soles of the feet when a person stands. This condition is also commonly called fallen arch or flatfoot, and in medical terms, it’s referred to as pes planus.

Everyone has flat feet during infancy. But throughout childhood, natural arches should develop in the feet as a person’s tendons and other soft tissues grow, strengthen, and tighten. However, some people do not develop arches during childhood for various reasons. Others develop arches but lose them as their tendons experience changes that cause the bottoms of their feet to flatten.

When a person has flat feet, they may experience gait issues, as the foot’s natural arch helps distribute a person’s body weight and absorbs shock produced by locomotion. While the condition of flat feet typically is not a serious condition, they may cause pain for some people. If the discomfort becomes problematic or the condition causes movement problems, a foot and ankle specialist can provide various treatments that can help.


Symptoms of Flat Feet

Flatfoot doesn’t always cause pain, and many people do not experience noticeable symptoms. However, some types of flat feet can cause discomfort, gait problems, and changes in the positioning of the feet. Common symptoms include:

  • Muscle aches or fatigue in the lower leg or foot
  • Leg or foot cramps or spasms
  • Pain in the arch, heel, or outside of the foot
  • Ankle pain
  • Changes in gait or pain when walking
  • Toe drift (when the front part of the foot and the toes point outward rather than straight)


Causes of Flat Feet

Some people develop flat feet because they’re genetically predisposed to the condition. Others develop fallen arches as they age due to leg or foot injuries or soft tissue abnormalities that affect the tendons’ ability to support the foot’s arch.

Risk factors that may increase a person’s likelihood of developing flat feet include:

  • Obesity
  • Rheumatoid arthritis
  • Achilles tendon injuries
  • Pregnancy
  • Cerebral palsy
  • Diabetes
  • Leg, foot, and ankle fractures
  • Wearing ill-fitting, non-supportive shoes


Types of Flat Feet

Various forms of flatfoot can develop, depending on whether a person has a genetic predisposition for the condition or it begins in adulthood and grows progressively worse. Types of flat feet include:

  • Rigid flatfoot: This condition typically manifests during adolescence and progresses as a person ages. It often causes pain and can be unilateral or bilateral.
  • Flexible flatfoot: This condition is the most common type of flat feet and typically develops during childhood or adolescence and grows more pronounced with age. Individuals with this type of flatfoot usually have an arch while sitting that disappears when they stand.
  • Vertical talus: This type of flatfoot (also known as rocker-bottom foot) occurs in people who are born with a congenital abnormality that causes the ankle’s talus bone to develop incorrectly. This genetic defect ultimately prevents arches from forming in the feet.
  • Adult-acquired flatfoot (fallen arch): This condition typically occurs when a person’s leg tendons become inflamed or experience other changes that affect their ability to support the arch.


How Is Flat Feet Diagnosed?

When flatfoot causes persistent discomfort or negatively affects a person’s gait, a visit to a podiatrist practice may become necessary. A foot and ankle specialist can diagnose the condition by assessing a person’s symptoms, evaluating their arches, and conducting X-rays to assess the bone structure of the feet.


Treatment Options for Flat Feet

If a foot and ankle specialist believes a person requires treatment for flat feet, they may recommend:

  • Physical therapy, which can improve mobility and flexibility of the arch area by strengthening and stretching the tissues in the feet and lower legs
  • Supportive devices, such as orthotics, braces, or custom-designed shoes, which can help support both the arch and the tissues that support the arch
  • Non-steroidal anti-inflammatory drugs (NSAIDs), which help quell painful inflammation in the leg and foot
  • Rest and ice to help alleviate swelling and pain

If a person suffers from pain associated with flat feet and conservative treatments fail to alleviate that discomfort, a podiatrist specialist may recommend surgical reconstruction. This is true for people with adult-onset flatfoot and those with congenital bone deformities that prevent arches from forming.

Depending on the condition, a surgeon may perform a combination of surgical procedures to correct bone and soft tissue abnormalities and improve the overall alignment of the feet.


[1] MedlinePlus.org. “Flat Feet.”

[2] ClevelandClinic.org. “Flat Feet.”

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