A flat foot is when one or both feet have no arches or their arches are too low. This can cause the feet to lie completely flat on the floor, impairing a person’s posture and causing pain and discomfort.

Doctors may refer to flatfoot arches as prolapsed arches.

There is an arch under the inside of the healthy foot when a person stands, with the arch rising slightly off the ground.

Things to know about the flat foot include:

• Children can develop flat feet, but they usually recover from them.

• Adults who develop flatfoot usually have a condition that affects their feet.

• Symptoms include pain, swelling, or stiffness affecting the arches of the feet, legs, and sometimes the back.

Flat feet only need treatment if they cause discomfort, indicate an underlying disorder, or lead to pain elsewhere in the body.

Some people seem to have shallow arches or no arches without having any problems at all. When flat feet cause symptoms, simple devices and exercises can help reduce discomfort.

What is a flat foot?

People with flat feet have a very low arch or no arch, which means one or both feet may be flat on the ground.

Flat feet can affect the body’s alignment when a person stands, walks, or runs. As a result, having flat feet can increase the likelihood of developing pain in the hips, knees, and ankles.

Flatfoot, also called pes planus, is a foot deformity in which the arch is not fully developed.

Flat feet in adults can cause foot pain in some people.

Flatfoot is a common foot condition in which there is a loss of the medial longitudinal arch.

How does a flat foot develop?

A typical human foot has 33 joints, which connect 26 different bones. It also has more than 100 muscles, tendons, and ligaments.

The ligaments provide spring to the step and help distribute body weight across the feet and legs. The structure of the arches determines how a person walks. ligaments must be solid and flexible to adapt to pressure and a variety of surfaces.

When people have flat feet, their feet may turn to the inner side when standing and walking. This is known as overpronation, and may also cause the feet to point outward.

People often develop flat feet in childhood. However, the condition can also develop in adulthood. Many people with flat feet experience no symptoms, but others will experience various symptoms that generally depend on the severity of the condition.

Types of flat feet

In general, there are two types of flat feet:

Flexible flat foot

This condition most commonly affects children. When the child stands, the arch of his foot will disappear. When sitting or walking on tiptoes the arch will appear and be visible again.

Rigid flat foot

When a person has a rigid flat foot, the arch will not form regardless of whether the patient puts weight on the foot or not, such as when standing. This condition can affect children and can develop in adults.

Symptoms of flat foot

The most common symptom of a flat foot is pain in the foot. This can be caused by tension in the muscles and associated ligaments.

Abnormal stresses on the knee and hip may lead to pain in these joints. These stresses are more likely to occur if the ankles turn inward.

Pain, and sometimes swelling or stiffness, most commonly affects the following parts of the body:

• Ankle

• Arch of the foot

• Calf

• Knee

• Hip

• Lower back

• The bottom of the foot

Flat feet can also cause uneven distribution of body weight. This can cause the shoes to wear unevenly or more quickly than usual, especially on one side, which can lead to further injuries. People may have difficulty walking or running symmetrically.

Causes and risk factors

There are several causes and factors involved in developing flat foot.

Common risks include:

• Obesity

• Pregnancy Diabetes

• Diabetes

• Trauma to the feet

• Having family members with this condition (Hereditary)

• Developing a condition that can affect the tendons

• Being of young age

• Being an older adult

Common causes include:

• Genetic factors, such as flat feet, can be passed from parents to children in genes

• Weak arches, which means that the arch is visible when the person is sitting but the foot is flat on the ground when the person is standing

• Foot or ankle injuries

• Stress on the arches of the feet due to excess weight

• Arthritis or rheumatoid arthritis

• Damage, dysfunction, or rupture of the posterior tibial tendon

• Diseases of the nervous system or muscles, such as spina bifida, muscular atrophy, or cerebral palsy

• Tarsal coalition, which causes the bones of the foot to fuse in an unusual way, which leads to stiffness and flattening of the feet

• Long-term use of the feet, which can weaken the posterior tibial tendon, the primary support structure for the arch of the foot, with age.

• Tendonitis, which is a tear from overuse, or other damage to the tendon

• Developmental abnormalities that can develop in childhood, with age, or after pregnancy

Flat foot in children

Babies are usually born with minimal visible arches, and it may take some time to develop arches that remain stable. When a child has flexible flat feet, this may not happen until after the age of five.

Most children with flat feet usually develop typical arches by the age of 10, and having flat feet during early childhood does not mean that a person will always have flat feet.

However, if a child has flat feet due to improper bone development or another condition, such as spina bifida, a doctor will often need to treat the underlying cause.

When flat feet develop in adulthood, there is usually an underlying medical cause.

The arch of the foot develops slowly over time and is fully developed by the age of two or three years. It is common for infants and young children to have flat feet.

Special exercises can help people with foot or arch pain.

Diagnosis

People with flat feet who do not experience pain or other symptoms usually do not need to consult a doctor.

However, anyone experiencing the following symptoms should seek medical advice:

• Flat feet that have recently developed

• Pain in the feet, ankles, or lower extremities

• Symptoms that do not improve with supportive, well-fitting shoes

• One or both feet become more flat

• Feeling like the feet are stiff, hard, heavy and unwieldy

The doctor will examine the feet from the front and back. The individual may need to stand on their tiptoes to allow the doctor to examine the form and function of each foot.

The doctor will also take into account the person’s medical history. They may order an X-ray, CT scan, MRI, or electromyography in some cases.

Exercises

Your podiatrist or physical therapist may recommend specific exercises to control flatfoot symptoms or prevent their progression.

In a 2020 study, researchers found that participants in this study’s gait and foot alignment improved after just 8 weeks of foot exercises.

The American Academy of Orthopedic Surgeons recommends the following exercises to improve strength and flexibility in the feet and ankles, which may help relieve the symptoms of flat feet.

Stretching the Achilles tendon

A tight Achilles tendon will encourage the foot to turn inward. Stretching aims to stretch the Achilles tendon and hind leg muscles.

To perform the heel cord extension, a person must:

1. Stand facing a wall and place one hand on the wall at eye level.

2. Place the leg that needs to be extended about one step behind the other leg, and place the heel firmly on the ground.

3. Bend the knee of the front leg until you feel a stretch in the back leg.

4. Hold for 30 seconds, then rest for 30 seconds.

5. Repeat for nine more times. It is necessary to avoid arching the back and keep it straight.

This exercise should be performed twice a day.

Roll the golf ball

This exercise requires a chair and a golf ball.

Sit on a chair with feet firmly on the floor. Place a golf ball under the foot, and roll it back and forth under the arch of the foot for two minutes to stretch the plantar fascia ligament.

Treatment of the flat foot

Some people with flat feet may automatically align their limbs in a way that prevents symptoms. People without symptoms usually do not need treatment. If flat feet are causing pain, supportive, well-fitted shoes can help, and extra-wide shoes can provide comfort.

Children usually need treatment for flat feet. If they are in pain, they may need to use insoles and fitted orthotics. Specially designed arch supports may relieve pressure on the arch and reduce pain if the foot turns inward too much.

Some bones do not develop properly in childhood, which may cause flat feet to persist from birth into adulthood. In these rare cases, surgical intervention may be necessary to separate the fused bones.

Adults can also use foot orthotics, and people with posterior tibial tendonitis may benefit from having a wedge inserted into their shoes along the inside edge of the orthosis. This should relieve some of the body’s load on the tendon tissue.

However, a person should use orthotics under the supervision of a doctor, because using the wrong orthotics or using them incorrectly can worsen symptoms.

A person can also take nonsteroidal anti-inflammatory medications to relieve pain. In cases where obesity is a contributing factor, your doctor may recommend eating a healthy diet and exercising to reach a healthy BMI and reduce stress on your braces.

Wearing an ankle brace may also be helpful to reduce inflammation. Doctors may advise some patients to rest until their symptoms improve and to avoid activities that may worsen their foot condition.

A person with arthritis or a ruptured tendon may find that a combination of using insoles and taking pain relievers can reduce their symptoms. If this treatment plan does not work, then surgery is necessary.

Outlook

Children with flexible flat feet often outgrow this condition. When a person has flat feet or it is caused by an underlying condition, the prognosis will depend on the severity of the symptoms and the treatment required.

Treatment may be difficult when the cause is a degenerative disease and symptoms worsen over time. When surgery is necessary, the prognosis is generally good. Exercising can help improve the outlook for some people. However, having flat feet may also mean that a person will need to avoid high-impact activities.

A person should consult a doctor to determine the best treatment plan for him.

Complications

People with other foot, ankle, or lower leg problems may find that flat feet have worsening symptoms.

Examples of this include:

• Achilles tendinitis

• Arthritis of the ankle

• Arthritis in the foot

• bunions

• hammer toe

• Plantar fasciitis, which is an inflammation of the ligaments on the sole

• Posterior tibial tendonitis

• Shin splints

Summary

Flat feet occur when a person has a weak or absent arch of the foot, often causing problems walking and sometimes pain. There are different causes of flat feet and not all types of the condition cause discomfort and symptoms.

When the condition develops in childhood, it usually goes away as the child grows. Treatment may be necessary if there is pain or impact on a person’s early life. This usually includes orthotics and anti-inflammatory medications. In rare cases, a person may need surgery.