Flat Feet Symptoms & Treatment

Flat feet (also known as flatfeet, flatfoot, pes planus, or fallen arches) is a condition characterized by the flattening of the foot when pressure is placed on it. It can occur in children or adults and may cause the foot to point outward and the entire sole to touch the floor in a standing position.

The condition isn’t always painful, but if flat feet are causing you pain and discomfort or are otherwise affecting your quality of life, it’s time to find a solution. Below, we’ve provided an overview of the flat foot condition—its causes, symptoms, diagnosis and treatment options. To learn more about flat feet and receive a personalized treatment approach, contact our world-class surgical team today!

Anatomy of the Foot Arch

The human foot is characterized by the presence of an arch that aids upright posture by helping to distribute the body’s weight across the feet and legs. This impacts the way a person walks and provides flexibility and a spring to each step. In a typical foot, the arch (which technically includes three arches—the medial and lateral longitudinal arches and the anterior transverse arch) allows for adaptation to a variety of different stresses and surfaces. However, in a person with flat feet, this adaptability may be lacking, and mobility may become uncomfortable or impaired. The presence of these arches also play a significant role in an individuals posture as well.

There are three main types of flat feet:

• Congenital flexible flat foot is characterized by an arch that appears normal when seated or on tiptoe but disappears under the pressure of the body’s weight when standing. It is common in children and may resolve on its own with customized insert support over time. Intervention is recommended when there is a history of strong family presence of painful flatfoot deformity.
• Acquired flexible flatfoot is characterized by a patient having an arch that is present during the time of early adulthood but then gradually gets lower and eventually flattened. Common causes of this are high levels of activity/exercises, pregnancy, long term use of minimal supportive shoe gear/barefoot walking.
• Rigid flat foot is characterized by the absence of a foot arch regardless of position or pressure. This tends to be a fixed deformity which requires orthotic support and may even require some bracing in more progressive deformities. 

Causes of Flat Feet

Flat feet is associated with many different causes. These can include:

• Arches that don’t develop typically during childhood
• Underlying foot conditions or deformities
• Barefoot walking/long term use of sandals and shoes with minimal support
• Injury (sometimes resulting in an abrupt arch collapse)
• Age (wear and tear)
• Obesity
• Arthritis
• Diabetes
• Pregnancy
• High impact activities/Sports
• Genetic weak arches

Symptoms of Flat Feet

Common symptoms of flat feet may include:

• Overpronation (inward rolling of the feet)
• Feet that point outward
• Pain, swelling, or stiffness in the heel, arch area, ankle, or other parts of the body (e.g., back)
• Uneven wearing down of one or both shoes
• Impaired posture
• Stiffness or clumsiness in manipulating the feet for various activities

Diagnostic Methods for Flat Feet

The diagnosis of flat feet always begins with taking a medical history and performing a detailed physical and detailed biomechanical examination. During the exam, your doctor may:

• Examine your feet from the front and back
• Watch you walking
• Test the strength of your feet and ankles
• Look at the wear pattern in your shoes

If your doctor feels that further diagnostic tests are necessary, they may order an X-ray, CT scan, ultrasounds, or MRI.

Treatment Options for Flat Feet

Flat feet doesn’t always need to be treated if it isn’t causing pain, discomfort, or mobility issues. That being said, it’s important to consult with a doctor if the condition develops suddenly, isn’t manageable over time with at-home treatments (see below), or feels increasingly painful, stiff, or rigid.

Flat feet can be addressed with non-surgical treatments or surgery, depending on the circumstances:

Non-Surgical Treatments

Non-surgical treatment options are almost always the first line of defense for flat feet. They may include:

• Customized foot orthoses addressing specific deformities observed

• Stretches to lengthen the Achilles tendon
• Physical therapy
• Weight loss (if the condition is associated with overweight or obesity)
• Over-the-counter medications
• Supportive footwear.
• Ankle bracing (to reduce inflammation)

Surgical Options for Flat Feet

Surgery may be indicated for the treatment of flat feet if non-surgical treatment options have not been effective. Your surgeon will recommend the right surgery based on the specifics of your condition. Common surgical treatments for flat feet include:

• Tendon and Ligament Repairs – To replace or repair damaged structures supporting the arch
• Osteotomies – These are bone cuts that are involved in restructuring bones in the foot and/or ankle
• Fusions – To immobilize joints severely impacted by arthritis or injury

• Implants – These are medical devices applied to the patient’s joints to help assist upholding the rearfoot of patients in better alignment. Sometimes, referred to as an internal orthotic.

Rehabilitation and Recovery

The rehabilitation and recovery process after flat feet surgery depends on the type of procedure performed. In most cases, several weeks of immobilization followed by physical therapy are required. Speak with your surgeon for more specifics on your condition, the correct treatment to manage, and the rest and rehab required to get you back up and running.

Frequently Asked Questions

Can flat feet be prevented?

Flat feet cannot always be prevented, but wearing supportive shoes and appropriate structural inserts, maintaining a healthy body weight, and adhering to good foot health practices can help.

How long is the recovery time after flat feet surgery?

Recovery time depends on the type of surgery performed but usually takes anywhere from several weeks to several months.

How effective are non-surgical treatments?

For many patients, non-surgical treatments can be highly effective for flat feet, especially in pediatric patients. If these approaches don’t improve quality of life, a surgical approach may be considered.

What are the potential risks of flat feet surgery?

Like all surgeries, flat feet surgeries come with risks like reactions to anesthesia, bleeding, and infection. For more specifics, speak directly with your surgeon.