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Flat Foot

    • What is flat foot?

      Flat foot or flat feet

      Flat foot or flat feet is a condition where one or both feet have little to no arch. As a result, the pads of the feet press into the ground while standing, without a visible arch.

      While all babies have flat feet at birth, arches usually form as they grow older and the ligaments and tendons in the feet and leg tighten. Some will grow to have high arches while others have medium or low arches, and some will continue to have flat feet into adulthood.

      In some people, arches will develop normally but later collapse - this is known as fallen arches and is often used as another term for flat feet.

      There are different types of flat feet:

      • Flexible flat feet

        This is the most common type, in which the arches are visible when not standing and disappear when standing or when weight is put on the feet. It is more common during childhood or teenage years and gets worse with age as tendons and ligaments in the arches stretch, tear and swell.

      • Rigid flat feet

        With rigid flat feet, there are no visible arches even when there is no weight on the feet. It may feel painful and be difficult to flex the feet up or down, or side to side. This could be due to abnormal bridges between the bones in the feet.

      • Adult-acquired flat feet (fallen arches)

        In this type of flat feet, the arches collapse or drop unexpectedly, causing the foot to turn outwards. It is most commonly caused by inflammation or a tear in the leg tendon that supports the arch and can be painful.  

      • Vertical talus

        This is a birth defect that prevents arches from forming, because the talus bone in the ankle is in the wrong position. As a result, the bottom of the foot resembles the curved bottom of a rocking chair, hence it is also called rocker-bottom foot.

      For most people, having flat feet is not a cause for concern and does not cause any pain. However, as the arch helps to distribute body weight, people with flat feet may experience pain or problems with walking, running or standing. This would be caused by the uneven distribution of weight or misalignment, which will show in footwear that wears down more in one area than others.

    • Some people have flat feet because it runs in the family (generalised ligamentous laxity). Others develop flat feet later in life. Some factors can increase your risk of flat feet, including:

      • Injuries to the Achilles tendon, foot or ankle
      • Cerebral palsy
      • Diabetes
      • Down Syndrome
      • Inflammation (tendonitis) or tearing of the posterior tibial tendon, which is the primary support structure for the foot’s arch
      • Muscular dystrophy
      • Obesity

    • Many people with flat feet do not experience any problems. For those that do, symptoms may include:

      • Leg cramps
      • Muscle ache, pain or numbness in the foot, ankle or leg
      • Pain in the arch, ankle, heel or outside of the foot, especially after prolonged walking or standing
      • Pain while walking
      • Changes in the way they walk
      • Callosities over the inside of the arch
      • Too many toes sign or toe drift (where the front part of the foot and toes point outward)

      It is advisable to seek medical advice for severe or sudden symptoms such as difficulty walking, problems with balance, stiff or painful feet or fallen arches (sudden development of flat feet).

    • To diagnose flat feet, the doctor will assess the symptoms and evaluate how flexible the foot and ankle might be; how the arches look while standing, sitting and walking. An X-ray or scan may be recommended to provide the doctor with a view of the bones and tendons to confirm the diagnosis.

    • Foot inserts for flat feet

      Non-surgical

      Treatment for flat feet is usually not necessary for those who do not experience any symptoms. In mild cases, there are ways to prevent it from getting worse and for people who experience severe symptoms, there are treatments that can help. If treatment is required, the doctor will recommend non-surgical options first, with surgery as a last resort.

      Non-surgical treatments can help to relieve pain and stiffness. These may include one or more of the following:

      • Rest and ice to relieve pain
      • Non-steroidal anti-inflammatory drugs (NSAIDs) to relieve inflammation, swelling and pain
      • Physical therapy to stretch and strengthen tendons and muscles, and help improve flexibility and mobility
      • Devices such as foot inserts known as orthotics, foot or leg braces, or customised shoes to provide support
      • Lifestyle changes such as an exercise and weight-loss programme to reduce pressure on the feet, or modifying daily activities to reduce the need to stand or walk for long periods

      Surgery

      Surgery for flat feet may be recommended if non-surgical treatments are unable to adequately relieve painful symptoms. Depending on the individual, different types of surgery may be performed to create an arch, repair tendons, or lengthen the Achilles tendon.

    • Surgery for flat feet may be recommended if non-surgical treatments are unable to adequately relieve painful symptoms. Depending on the individual, different types of surgery may be performed to create an arch, repair tendons, or lengthen the Achilles tendon.

      • Arthritis
      • Bone spurs
      • Bunions
      • Callosities
      • Tendon and ligament problems

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