Table of ContentsView AllTable of ContentsSymptomsCausesDiagnosisTreatmentCopingFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
Symptoms
Causes
Diagnosis
Treatment
Coping
Frequently Asked Questions
Flat feet, also called pes planus, is a deformity that occurs when the arch of the foot collapses and comes into complete or near-complete contact with the ground. The condition may be congenital (occurring at the time of birth) or acquired (developing over time, most often as a result of age or injury).
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Arch Pain Causes and Treatments
Flat Feet Symptoms
Leg and back pain are also common as the instability of your gait and posture can place undue stress on these joints
Over time, simple movements like standing on your toes can become unbearable asarthritisfurther limits the range of motion between the bones of your foot. This can affect how you walk or run, leading to a characteristic flat-footed gait.
Between 20% and 30% of the general population has some degree of flat-footedness.
Flat feet are typically associated with excessive pronation of the foot.As opposed to normal pronation (in which the foot rolls evenly from the heel to toe), overpronation causes the ankle side of the foot to roll inward, creating a flat appearance.
Because of their tendency to overpronate, flat feet are less able to absorb shock, placing persistent stress on the feet, ankles, and knees. Overpronation causes the excessive rotation of the tibia (shin bone), increasing the risk of shin splints.
The inward tilt of the foot places further strain on the tendons and ligaments of the lower extremities.Achilles tendinitis(inflammation of the Achilles tendon) and knee pain are common consequences.
The cause and treatment of flat feet differ based on the person’s age. Flat feet in children will often resolve without intervention, while “fallen arches” in adults tend to be permanent and non-reversible.
Flat Feet in Children
Flat feet are commonly associated with genetic disorders that first develop in childhood, including:
Flat feet may come and go as a child develops. During growth spurts, changes in the tightness of the calf muscles may cause temporary flat-footedness. A similar example is genu valgum, also known as knock-knees, which usually occurs between the ages of 2 and 5, and typically corrects itself during adolescence.
Flat feet in children may only become apparent between adolescence and the early teen years when abnormalities in gait and pronation become more apparent. Kids may not be as fast as their peers, or they may experience pain with running or sporting events. If left untreated, the disorder can progress and worsen in later life.
Flat Feet in Adults
“Fallen arches” is a term used to describe the collapse of the bones and connective tissues of the midfoot. It is commonly associated with the deterioration of the posterior tibialtendon, which runs along your inner ankle.
Faulty foot mechanics can also take their toll on the structure of arch, leading to the progressive loosening ofligamentsthat support the foot bones.
Among some of the other conditions linked to adult-acquired flat foot:
Shoes can also contribute. A compressed toe box (which prevents the toes from resting in a natural position) and an elevated heel (which causes hyperextension of the arch muscles and decreased dorsiflexion of the ankle) all serve to undermine the strength and flexibility of the underside of the foot, increasing the risk of collapse.
Fallen arches are almost always permanent. With that being said, many people will have a condition known asflexible flat footin which the arch is visible when the foot is lifted but disappears once the foot is placed on the ground. Flexible flat feet can result in pain in the foot, along the shin bone, and in the lower back, hip, or knee.
However, as a person ages, the condition can worsen and cause the collapse of one or both arches. Over time, this can lead to a condition known asrigid flat footin which the sole is rigidly flat even when the foot is lifted.
Visual Examination
Imaging Tests
If you are experiencing a lot offoot pain, your healthcare provider may order imaging tests to help pinpoint the underlying cause. Among the imaging tests used:
Treatments
The treatment of flat feet can vary in children and adults. In either case, a conservative approach is usually preferred with surgery reserved for only the more severe cases.
Treatment in Children
Children who go barefoot on varied terrain are more likely to have normal arch development, usually between the ages of 4 and 6. This is because they are strengthening the intrinsic muscles that help to create the arch.By contrast, closed-toe shoes (particularly those with narrow toes) may have the opposite effect, increasing the risk of lax ligaments.
Current evidence suggests the use of orthotics in children with flat feet is rarely beneficial.The exception may be in children with congenital foot deformities. Surgery would be performed no later than the early teens, when the bone structure is still developing. Orthotics would then be used to ensure the foot heals in the correct position.
An Overview of Foot Orthotics
Non-Surgical Treatment in Adults
Fallen arches in adults often require no treatment. People with persistent or severe symptoms may benefit from orthotic arch supports and foot gymnastics. Before surgery is considered, conservative treatments such as non-steroidal anti-inflammatory medications (NSAIDs), corticosteroids, and orthotics or bracing are tried.
Orthotic supports are used to change the structure of your foot. Over the course of weeks or months, layers will be added, allowing you to gradually adapt to the sensation with minimal discomfort. Once prescribed, arch supports should be worn for the rest of your life.
Ankle foot orthoses(AFOs) are one treatment option for some people. These orthotics fit at the ankle joint to improve your walking gait and prevent or correct ankle or foot deformities.They can be used to treat theposterior tibial tendon, which helps to support the arch of the foot.
An Overview of Flat Feet
Surgery
If needed, flat foot surgery can provide lasting pain relief and may even create an arch where none existed. Because the causes and location of the pain can vary, no two surgeries are ever alike. The surgical approach will ultimately be based on your age, your symptoms, and the nature of the structural deformity.
There are two main types of surgery to treat flat feet. The most common is reconstructive surgery, which repositions the tendons and fuses certain joints to properly realign the foot. Another procedure uses a subtalar implant to support the arch. The metal implant is put in the back of the foot to correct flat feet.
Foot surgery can be costly and may require extensive recovery time. Moreover, insurance companies tend to be reluctant to approve the procedure until all other options have been exhausted. Even then, approvals can be a challenge.
In some cases, approvals will only be obtained after an acute injury, such as a tendon rupture, leaves the healthcare provider with no other option but surgery.
A somewhat less costly option is to have custom-made insoles, which you can slip in and out of your pairs of shoes as needed. Some online retailers will send you a plasticine slab to create the foot mold, which they can use to create different types of insoles for running, walking, or work. The cost is usually between $100 to $150 per pair.
But in many cases, custom-made shoes or orthotics are not necessary. All you may really need is the appropriate shoe fitted properly. Surprisingly, many foot problems stem from wearing poorly fitted and sized shoes.
When selecting shoes, invest in those that compensate for any abnormalities in your gait. Examples include:
The shoes should bend at the toe to allow natural foot movement rather than having a completely rigid sole. You should also avoid shoes with high arches as this may cause pain and bruising.
A Word From Verywell
Many people will wait to see a podiatrist until their foot pain becomes unbearable. The problem with this is that any damage done to the foot may already be irreversible or difficult to correct.
In the end, you need to see a podiatrist if the discomfort is keeping you from walking, standing, or exercising. The same applies if you find yourself favoring one foot over the other. By treating these conditions early, you may be able to prevent knee, hip, or lower back pain in later life.
Pes planus, which in Latin literally translates to foot (pes) and flat (planus).
No. Even though the terms often are used interchangeably, they are not the same thing. Strictly speaking, “flat feet” refers to feet that have a naturally low arch. Collapsed arches, however, is a diagnosis in which the posterior tibial tendon, which pulls up on the bottom of the foot to help with walking, deteriorates over time.
17 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Penn Medicine.Flat foot and high arches treatment.Pita-fernandez S, Gonzalez-martin C, Alonso-tajes F, et al.Flat foot in a random population and its impact on quality of life and functionality.J Clin Diagn Res. 2017;11(4):LC22-LC27. doi:10.7860/JCDR/2017/24362.9697Cleveland Clinic.Overpronation.Patient.info.Shin splints (medial tibial stress syndrome).American Academy of Family Physicians.Flat feet.American Academy of Orthopaedic Surgeons.Vertical talus.MedlinePlus.Ehlers-Danlos syndrome.Jankowicz-szymanska A, Mikolajczyk E.Genu valgum and flat feet in children with healthy and excessive body weight.Pediatr Phys Ther. 2016;28(2):200-6. doi:10.1097/PEP.0000000000000246Cleveland Clinic.Flat feet.Park J, Lee SG, Bae J, Lee JC.The correlation between calcaneal valgus angle and asymmetrical thoracic-lumbar rotation angles in patients with adolescent scoliosis.J Phys Ther Sci. 2015;27(12):3895-9. doi:10.1589/jpts.27.3895American College of Foot and Ankle Surgeons.Flexible flatfoot.Hollander K, De villiers JE, Sehner S, et al.Growing-up (habitually) barefoot influences the development of foot and arch morphology in children and adolescents.Sci Rep. 2017;7(1):8079. doi:10.1038/s41598-017-07868-4American Academy of Orthopaedic Surgeons.Flexible flatfoot in children.Vulcano E, Deland JT, Ellis SJ.Approach and treatment of the adult acquired flatfoot deformity.Curr Rev Musculoskelet Med. 2013;6(4):294-303. doi:10.1007/s12178-013-9173-zZhou C, Yang Z, Li K, Ye X.Research and development of ankle-foot orthoses: A review.Sensors (Basel). 2022 Sep 1;22(17):6596. doi:10.3390/s22176596.Operation Military Kids.Can you join the military with flat feet?Columbia Orthopedics.Flatfoot, or collapsed arch.Additional ReadingBanwell H, Mackintosh S, Thewlis D.Foot orthoses for adults with flexible pes planus: a systematic review.J Foot Ankle Res.2014;7:23. doi:10.1186/1757-1146-7-23.Benedetti M, Ceccarelli F, Berti L, et al.Diagnosis of flexible flat foot in children: A systematic clinical approach.Orthopedics. 2011; 34(2):94-20101221-04. doi:10.3928/01477447-20101221-04.
17 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Penn Medicine.Flat foot and high arches treatment.Pita-fernandez S, Gonzalez-martin C, Alonso-tajes F, et al.Flat foot in a random population and its impact on quality of life and functionality.J Clin Diagn Res. 2017;11(4):LC22-LC27. doi:10.7860/JCDR/2017/24362.9697Cleveland Clinic.Overpronation.Patient.info.Shin splints (medial tibial stress syndrome).American Academy of Family Physicians.Flat feet.American Academy of Orthopaedic Surgeons.Vertical talus.MedlinePlus.Ehlers-Danlos syndrome.Jankowicz-szymanska A, Mikolajczyk E.Genu valgum and flat feet in children with healthy and excessive body weight.Pediatr Phys Ther. 2016;28(2):200-6. doi:10.1097/PEP.0000000000000246Cleveland Clinic.Flat feet.Park J, Lee SG, Bae J, Lee JC.The correlation between calcaneal valgus angle and asymmetrical thoracic-lumbar rotation angles in patients with adolescent scoliosis.J Phys Ther Sci. 2015;27(12):3895-9. doi:10.1589/jpts.27.3895American College of Foot and Ankle Surgeons.Flexible flatfoot.Hollander K, De villiers JE, Sehner S, et al.Growing-up (habitually) barefoot influences the development of foot and arch morphology in children and adolescents.Sci Rep. 2017;7(1):8079. doi:10.1038/s41598-017-07868-4American Academy of Orthopaedic Surgeons.Flexible flatfoot in children.Vulcano E, Deland JT, Ellis SJ.Approach and treatment of the adult acquired flatfoot deformity.Curr Rev Musculoskelet Med. 2013;6(4):294-303. doi:10.1007/s12178-013-9173-zZhou C, Yang Z, Li K, Ye X.Research and development of ankle-foot orthoses: A review.Sensors (Basel). 2022 Sep 1;22(17):6596. doi:10.3390/s22176596.Operation Military Kids.Can you join the military with flat feet?Columbia Orthopedics.Flatfoot, or collapsed arch.Additional ReadingBanwell H, Mackintosh S, Thewlis D.Foot orthoses for adults with flexible pes planus: a systematic review.J Foot Ankle Res.2014;7:23. doi:10.1186/1757-1146-7-23.Benedetti M, Ceccarelli F, Berti L, et al.Diagnosis of flexible flat foot in children: A systematic clinical approach.Orthopedics. 2011; 34(2):94-20101221-04. doi:10.3928/01477447-20101221-04.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Penn Medicine.Flat foot and high arches treatment.Pita-fernandez S, Gonzalez-martin C, Alonso-tajes F, et al.Flat foot in a random population and its impact on quality of life and functionality.J Clin Diagn Res. 2017;11(4):LC22-LC27. doi:10.7860/JCDR/2017/24362.9697Cleveland Clinic.Overpronation.Patient.info.Shin splints (medial tibial stress syndrome).American Academy of Family Physicians.Flat feet.American Academy of Orthopaedic Surgeons.Vertical talus.MedlinePlus.Ehlers-Danlos syndrome.Jankowicz-szymanska A, Mikolajczyk E.Genu valgum and flat feet in children with healthy and excessive body weight.Pediatr Phys Ther. 2016;28(2):200-6. doi:10.1097/PEP.0000000000000246Cleveland Clinic.Flat feet.Park J, Lee SG, Bae J, Lee JC.The correlation between calcaneal valgus angle and asymmetrical thoracic-lumbar rotation angles in patients with adolescent scoliosis.J Phys Ther Sci. 2015;27(12):3895-9. doi:10.1589/jpts.27.3895American College of Foot and Ankle Surgeons.Flexible flatfoot.Hollander K, De villiers JE, Sehner S, et al.Growing-up (habitually) barefoot influences the development of foot and arch morphology in children and adolescents.Sci Rep. 2017;7(1):8079. doi:10.1038/s41598-017-07868-4American Academy of Orthopaedic Surgeons.Flexible flatfoot in children.Vulcano E, Deland JT, Ellis SJ.Approach and treatment of the adult acquired flatfoot deformity.Curr Rev Musculoskelet Med. 2013;6(4):294-303. doi:10.1007/s12178-013-9173-zZhou C, Yang Z, Li K, Ye X.Research and development of ankle-foot orthoses: A review.Sensors (Basel). 2022 Sep 1;22(17):6596. doi:10.3390/s22176596.Operation Military Kids.Can you join the military with flat feet?Columbia Orthopedics.Flatfoot, or collapsed arch.
Penn Medicine.Flat foot and high arches treatment.
Pita-fernandez S, Gonzalez-martin C, Alonso-tajes F, et al.Flat foot in a random population and its impact on quality of life and functionality.J Clin Diagn Res. 2017;11(4):LC22-LC27. doi:10.7860/JCDR/2017/24362.9697
Cleveland Clinic.Overpronation.
Patient.info.Shin splints (medial tibial stress syndrome).
American Academy of Family Physicians.Flat feet.
American Academy of Orthopaedic Surgeons.Vertical talus.
MedlinePlus.Ehlers-Danlos syndrome.
Jankowicz-szymanska A, Mikolajczyk E.Genu valgum and flat feet in children with healthy and excessive body weight.Pediatr Phys Ther. 2016;28(2):200-6. doi:10.1097/PEP.0000000000000246
Cleveland Clinic.Flat feet.
Park J, Lee SG, Bae J, Lee JC.The correlation between calcaneal valgus angle and asymmetrical thoracic-lumbar rotation angles in patients with adolescent scoliosis.J Phys Ther Sci. 2015;27(12):3895-9. doi:10.1589/jpts.27.3895
American College of Foot and Ankle Surgeons.Flexible flatfoot.
Hollander K, De villiers JE, Sehner S, et al.Growing-up (habitually) barefoot influences the development of foot and arch morphology in children and adolescents.Sci Rep. 2017;7(1):8079. doi:10.1038/s41598-017-07868-4
American Academy of Orthopaedic Surgeons.Flexible flatfoot in children.
Vulcano E, Deland JT, Ellis SJ.Approach and treatment of the adult acquired flatfoot deformity.Curr Rev Musculoskelet Med. 2013;6(4):294-303. doi:10.1007/s12178-013-9173-z
Zhou C, Yang Z, Li K, Ye X.Research and development of ankle-foot orthoses: A review.Sensors (Basel). 2022 Sep 1;22(17):6596. doi:10.3390/s22176596.
Operation Military Kids.Can you join the military with flat feet?
Columbia Orthopedics.Flatfoot, or collapsed arch.
Banwell H, Mackintosh S, Thewlis D.Foot orthoses for adults with flexible pes planus: a systematic review.J Foot Ankle Res.2014;7:23. doi:10.1186/1757-1146-7-23.Benedetti M, Ceccarelli F, Berti L, et al.Diagnosis of flexible flat foot in children: A systematic clinical approach.Orthopedics. 2011; 34(2):94-20101221-04. doi:10.3928/01477447-20101221-04.
Banwell H, Mackintosh S, Thewlis D.Foot orthoses for adults with flexible pes planus: a systematic review.J Foot Ankle Res.2014;7:23. doi:10.1186/1757-1146-7-23.
Benedetti M, Ceccarelli F, Berti L, et al.Diagnosis of flexible flat foot in children: A systematic clinical approach.Orthopedics. 2011; 34(2):94-20101221-04. doi:10.3928/01477447-20101221-04.
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