If you have flat feet, your feet do not have a normal arch when standing, possibly causing pain when you do extensive physical activity.
The condition, also referred to as pes planus or fallen arches, is normal in infants and usually disappears by age 2 or 3 as the ligaments and tendons in the foot and leg tighten. However, it can last through to adulthood. It is very common: twenty-five percent of American adults have this condition. Having flat feet is rarely serious.
In some cases, flat feet are caused by injuries or illness, creating problems with walking, running, or standing for long hours.
Types of Flat Feet
Flexible Flat Foot
Flexible flat foot is the most common type of the condition and usually does not cause pain. If you have this type, it has been present since childhood. The arch in your feet appears only when you lift them off the ground, and your soles touch the ground fully when you place your feet on the ground.
Short Achilles Tendon
If the tendon that connects your heel bone to your calf muscle (Achilles tendon) is too short, you might experience pain when walking and running. This condition causes the heel to lift prematurely when the affected person is walking or running.
Posterior Tibial Tendon Dysfunction
This type of flat foot is acquired in adulthood when the tendon that connects your calf muscle to the inside of your ankle is injured or swollen. Your arch does not receive the support it needs, resulting in pain on the inside of the foot and ankle, as well as on the outside of the ankle. Depending on the cause, you might have the condition in one or both feet.
What Causes Flat Feet?
The cause of flat feet is related to the tissues and bones in your feet and lower legs. In babies and toddlers, the condition is normal because it takes time for the tendons to tighten and form an arch. In rare cases, the bones in children’s feet become fused, causing pain.
In some adults, this tightening does not occur fully, resulting in flat feet. As some people age or sustain an injury, there the tendons in one or both feet may become damaged. The condition is also associated with diseases such as cerebral palsy and muscular dystrophy.
Who Is at Risk?
You are more likely to have flat feet if the condition runs in your family. If you are highly athletic and physically active, your risk is higher due to the possibility of foot and ankle injuries. Older people who are prone to falls or physical injury are also more at risk. People with diseases that affect the muscles—for example, cerebral palsy—also have an increased risk.
Recognizing the Symptoms
There is no cause for concern if your feet are flat and you have no pain. If you experience aches in your feet after walking long distances or standing for many hours, flat feet may be the cause. You may also feel pain in your lower legs and ankles. Your feet may feel stiff or numb, have calluses and possibly lean toward each other.
When to See a Podiatrist
If you have foot pain and/or your feet are causing problems with walking and running, see a podiatrist or your regular doctor. Diagnosing the problem requires a few tests. Your doctor will look for an arch in your feet as you stand on your toes. If an arch exists, you do not need treatment for flat feet. The podiatrist will also look for flexion in your ankle. If you are having difficulty flexing the foot and/or an arch does not appear, your doctor will order more tests, such as a foot X-ray and scans to examine the bones and tendons in your feet.
Treating Flat Feet
Supporting your feet is usually a first step in recovering from the condition. Your doctor may recommend that you wear orthotics, which are inserts that go inside your shoes to support your feet. For children, the doctor may prescribe special shoes or heel cups until their feet are fully formed.
Reducing pain from flat feet may involve incorporating some changes in your daily routines. For example, your doctor may recommend a diet and exercise program for weight loss to reduce the pressure on your feet. You may be advised against standing or walking for prolonged periods.
Depending on the cause of your condition, you may have sustained pain and inflammation. The doctor might prescribe medication to reduce the discomfort from these symptoms. Nonsteroidal anti-inflammatory (NSAIDS) medications are typically used to relieve your swelling and pain.
Surgery may be an option in more serious cases and is usually the last resort. The orthopedic surgeon may create an arch in your feet, repair tendons, or fuse your bones or joints. If your Achilles tendon is too short, the surgeon can lengthen it to decrease your pain.
What Is the Long-Term Outlook?
Some people find relief from wearing special shoes or shoe supports, and although surgery is usually a last resort, its outcome is usually positive. Surgery complications, though rare, can include infection, poor ankle movement, improperly healing bones, or persistent pain.
Preventing Flat Feet
Flat feet tend to be a hereditary condition and is usually not preventable. You can prevent the condition from worsening and causing excessive pain by taking precautions such as wearing shoes that fit well and provide the necessary foot support.