Flatfeet, also known as fallen arches or pes planus, occur when the structural arch on the inside of the foot is flattened, allowing the entire sole of the foot to touch the floor when you are standing.
[Image of the anatomy of the human foot arch]
Key Point: This condition is usually painless and a normal variation of foot anatomy. If you are not experiencing physical pain or mobility issues, medical treatment is generally not necessary.
Symptoms
Most people with flatfeet have no noticeable symptoms. However, if the lack of an arch causes misalignment in the rest of your body, you may experience:
- Pain: Specifically localized in the heel or the mid-foot (arch) area.
- Swelling: Mild to moderate swelling along the inside of the ankle.
- Leg Fatigue: Your feet and calves feel unusually tired or "heavy" after short periods of walking.
- Back & Knee Pain: Because the feet provide the foundation for your posture, misalignment can travel up the kinetic chain, causing chronic pain in the knees, hips, and lower back.
Want to check the height of your arches at home?
- Wet the soles of both feet thoroughly.
- Stand naturally on a flat surface that will show your footprint (like a concrete walkway or a dark piece of construction paper).
- Result: If the footprint looks like a solid brick with no distinct curve inward where the arch should be, you likely have flat feet.
When to See a Doctor
You should consult a podiatrist or orthopedic specialist if your flatfeet develop suddenly, if you experience persistent pain that does not improve with supportive shoes, or if your feet feel stiff or numb. It is also important to seek medical advice if you notice that your arches are "falling" more on one side than the other, as this can indicate a specific tendon injury.
Causes
Flatfeet can be present from birth or can develop later in life due to several factors:
- Normal Development: Arches typically develop during early childhood. In some individuals, the tendons never tighten fully, and a permanent arch never forms.
- Aging & Wear: Decades of daily wear and tear can eventually weaken the Posterior Tibial Tendon, which is the primary structure supporting the arch.
- Injury: A traumatic fracture, dislocation, or severe sprain in the foot or ankle.
- Obesity: Carrying excess body weight places constant, heavy pressure on the arches, which can cause them to collapse over time.
Complications
When the feet rotate inward too much (overpronation), it can lead to several secondary issues:
- Plantar Fasciitis: Painful inflammation of the thick band of tissue connecting the heel bone to the toes.
- Shin Splints: Exercise-related pain along the inner edge of the shinbone.
- Bunions: A bony, painful bump that forms at the joint at the base of your big toe.
- Knee & Hip Pain: Chronic discomfort caused by the legs rotating inward to compensate for the flat base.
Diagnosis
A doctor will observe your feet from the front and back while you stand and walk. They may also inspect the wear pattern on your shoes; people with flatfeet typically show excessive wear on the inside of the heel and sole.
- X-Rays: To check for structural bone alignment and signs of arthritis.
- Ultrasound or MRI: Used if a doctor suspects damage to the tendons or soft tissues.
Treatment
Treatment is only necessary if you are experiencing pain or if the condition is interfering with your mobility.
1. Arch Supports (Orthotics)
Over-the-counter arch supports (orthotics) can significantly reduce the pressure on your feet. If these do not provide enough relief, a specialist can design custom-molded orthotics tailored to the exact contours of your feet.
2. Physical Therapy & Exercises
- Heel Cord Stretch: Flatfeet are often associated with a tight Achilles tendon. Stretching the heel cord daily can help improve flexibility and reduce pain.
- Golf Ball Roll: Rolling a golf ball or frozen water bottle under your foot while sitting can help massage and stretch the plantar fascia.
3. Supportive Footwear
Avoid wearing flimsy sandals, flip-flops, or high heels for long periods. Instead, look for shoes with a firm, supportive sole and built-in arch support to help stabilize the foot.
4. Surgery
Surgery is rarely performed solely to create an arch. It is usually reserved for more complex cases, such as repairing a completely ruptured tendon or fusing joints in cases of severe, painful bone deformity.
Frequently Asked Questions (FAQs)
Do all children have flat feet?
Yes, most infants and toddlers appear to have flat feet. This is because a child's arch typically doesn't fully develop until between the ages of 3 and 6. As they grow and their tendons tighten, the arch becomes visible.
Can I still run or play sports with flat feet?
Absolutely. Many professional athletes have flat feet. However, it is vital to wear high-quality, supportive athletic shoes—often specifically labeled for "stability" or "motion control"—to prevent overpronation and injuries like shin splints.
References
- American Academy of Orthopaedic Surgeons (AAOS)
- American Podiatric Medical Association (APMA)
- Mayo Clinic - Flatfeet Overview
Reviewed & Sources: WHO, CDC, medical textbooks
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