If you have flat feet, your feet don’t have a normal arch
when you’re standing. This can cause pain when you do extensive physical
The condition is referred to as pes planus, or fallen
arches. It’s normal in infants and usually disappears by age 2 or 3 as the
ligaments and tendons in the foot and leg tighten. But, it can last through adulthood:
25 percent of American adults have this condition. Having flat feet is rarely
In some cases, flat feet are caused by injuries or illness,
creating problems with walking, running, or standing for hours.
Types of Flat Feet
Flexible Flat Foot
Flexible flat foot is the most common type. The arches in
your feet appear only when you lift them off the ground, and your soles touch
the ground fully when you place your feet on the ground.
This type starts in childhood and usually doesn’t cause
Short Achilles Tendon
Your Achilles tendon connects your heel bone to your calf muscle.
too short, you might experience pain when walking and running. This condition
causes the heel to lift prematurely when you’re 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, swollen,
or torn. If your arch doesn’t receive the support it needs, you’ll
have pain on the inside of your 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
What Causes Flat Feet?
Flat feet are related to the tissues and bones in your feet
and lower legs. The condition is normal in babies and toddlers because it takes
time for the tendons to tighten and form an arch. In rare cases, the bones in a
child’s feet become fused, causing pain.
If this tightening doesn’t occur fully, it can result in
flat feet. As you age or sustain injuries, the tendons in one or both feet may
become damaged. The condition is also associated with diseases such as cerebral palsy
Who Is at Risk?
You’re more likely to have flat feet if the condition runs
in your family. If you’re 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. Other risk factors include obesity, hypertension, and diabetes mellitus.
Recognizing the Symptoms
There is no cause for concern if your feet are flat and you
have no pain. However, if your feet ache 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 or your feet are causing problems with
walking and running, see an orthopedic surgeon, podiatrist, or your regular
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 don’t need treatment for flat feet. Your doctor will also look for
flexion in your ankle.
If you’re having difficulty flexing your foot or an arch doesn’t
appear, your doctor will order more tests, such as a foot X-ray or a scan to
examine the bones and tendons in your feet.
Treating Flat Feet
Supporting your feet is usually a first step in treating 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 the feet are fully formed.
Reducing pain from flat feet may involve incorporating some
changes in your daily routine. For example, your doctor may recommend a diet
and exercise program for weight loss to reduce the pressure on your feet. They
may recommend not standing or walking for prolonged periods.
Depending on the cause of your condition, you may have sustained
pain and inflammation. Your doctor might prescribe medication to reduce the
discomfort from these symptoms. Nonsteroidal anti-inflammatory medications can
relieve swelling and pain.
Surgery may be an option in more serious cases and is
usually the last resort. Your 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. Surgery is usually a last resort, but 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 hereditary and usually can’t be
prevented. But, 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.