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Flat Feet - What You Need to Know

by Jaydee Vykoukal, PT, DPT April 19, 2019 0 Comments

flat feet

Flat feet occur when the arches of the feet do not hold their normal shape, resulting in the entire middle of the foot touching the floor. Often the condition is painless, but for some people with flat feet pain can develop in the heel or arch area. Fallen arches can lead to not only foot problems, but also issues in the lower body or spine. Keep scrolling to learn more about flat feet, the causes, risk factors, symptoms you may experience and how to go about diagnosing.

What are Flat Feet?

If you have flat feet, it means that your entire foot touches the ground when you are standing. The medical term for flat feet is pes planus, but the condition is also known as fallen arches, collapsed arches, or pronated feet.

Interestingly, all babies are born with flat feet. From the age of three onward, the arch of the foot begins to develop with weight bearing activity that tightens the tendons and other connective tissue in the feet. Sometimes, this development fails to occur and the person is left with flat feet. Other times, flat feet can occur during adulthood.

People with flat feet may experience other problems due to misalignment of the body, such as ankle pain, knee pain, hip pain, and even low back pain.

Rigid Flat Feet vs. Flexible Flat Feet

There are two types of flat feet:

  • Flexible Flat Feet

    In the case of a flexible flatfoot, the foot appears flat when you are standing up, but the arch is visible when sitting down, as there is no weight on the foot. Painless, flexible flat feet typically don’t cause problems.

  • Rigid Flat Feet

    There is no visible arch when sitting or standing. Rigid flat feet are more likely to cause pain and other issues than flexible flat feet. This is because the feet are not able to properly absorb shock with normal daily activities, putting excessive strain on the entire lower body.

Posterior Tibialis Dysfunction

There is technically a third type of flat foot. This condition occurs with muscle dysfunction. The posterior tibialis plays a key role in supporting the arch. Thus, if it becomes swollen or painful it can lead to a fallen arch.

What Causes Flat Feet?

Flat feet are normal in infants and toddlers, but should not occur in adults. Yet, as many as 8% of adults are reported to have flat feet. In older children and adults, the most common flat feet causes include:

  • Weak tendons in the foot, which can be a natural effect of aging
  • Overstretched ligaments in the foot secondary injury or chronic disease
  • Heredity
  • Abnormal foot development due to genetics or a condition such as cerebral palsy
  • Injury to the foot, such as a fracture or torn tendon
  • Arthritis

Risk Factors

Anyone can be at risk of flat feet, but some people are more likely to develop the condition than others. The factors that increase your risk of flat feet include:

  • Obesity
  • Genetics; having a family member with flat feet
  • Having Down Syndrome
  • Injury to your foot or ankle
  • Conditions such as arthritis and diabetes
  • Getting older

Flat Feet Symptoms

The most obvious sign of flat feet is the absence of an arch, either when sitting, standing, or both. Aside from this, most people experience no other symptoms.

Occasionally, people may have:

  • Foot pain, especially in the heel or ankle
  • Pain that gets worse during activities or when standing for long periods
  • Swelling on the inside of the ankle

In severe or long-term cases of flat feet, pain in the knee, hips, or low back may occur due to biomechanical changes.

Flat Feet Diagnosis

See your doctor or podiatrist if you are concerned about how having flat feet might affect your quality of life. It is especially important to make an appointment if you have:

  • Feet that get fatigued easily
  • Pain in the feet after standing
  • Difficulty moving your heel
  • Difficulty standing on your toes
  • Arthritis, diabetes, or another medical condition

To diagnose flat feet, the podiatrist will examine and check your foot arch. They may ask you to stand on your toes. It can be helpful to bring a pair of well-worn shoes with you so they can check the wear pattern for signs of misalignment.

Depending on your symptoms, your doctor may order an imaging test of your feet, such as an X-ray, CT scan, or MRI scan to rule out secondary complications such as tendon injury, sprains, or fracture. They may even prescribe orthopaedic insoles.

Do I Have Flat Feet?

arch type test

Although it can be helpful to seek a medical advice for proper diagnosis, you can perform an at-home test to check for flat feet, high or normal arches. To do this:

  1. Wet your feet.
  2. Step onto a flat surface that will show your footprint. Good options are a dry concrete surface or a large, brown paper bag.
  3. Step off the surface and examine the prints. If you can see an imprint of your entire foot—including the area where the arch should be—then you probably have flat feet.


Most people with flat feet do not experience problems. Many do not require treatment. But if you have rigid flat feet, or you regularly experience pain, then you may be at higher risk of flat feet problems.

The most common problem is that flat feet exacerbate the symptoms of other conditions in the feet, ankles, or legs. These include:

Flat feet can also throw off the rest of your body alignment which can be problematic with any weight bearing activity, when running, or engaging in other high-impact activities. It places you at higher risk of pain in the hips, back, and knees.

How to Prevent Flat Feet

It’s not always possible to prevent flat feet, particularly when flat feet result from developmental issues during childhood. However, most cases of flat feet during adulthood can be avoided. To prevent flat feet:

  • Regularly exercise and stretch the intrinsic muscles of the foot and ankle
  • Wear supportive shoes that support your foot’s natural arch shape
  • Spend time out of your shoes and doing activities barefoot when possible to regularly (and fully) use the muscles in the foot
  • Avoid high heels
  • Use arch supports and inserts
  • Maintain a healthy body weight
  • Alternate between high-impact and low-impact activities to avoid excess stress on the feet and arches

How to Prevent Flat Foot Pain

Healing Painful Flat Feet for Good

If you have painful flat feet, the first port of call should be your doctor, who can make a diagnosis and help you formulate an effective treatment plan. Luckily, conservative treatments often resolve the pain and swelling associated with the condition.

The most effective home remedies involve using orthotics for flat feet. Some of the best options include special arch supports and shoe inserts for flat feet. You can also try stretching exercises, physical therapy, rest, ice, and over-the-counter pain relieving medications.

Finally, choose your footwear wisely. High-quality shoes with good arch support can prevent and alleviate the symptoms of flat feet, as well as many other painful foot conditions.


Flat Feet Products

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Flat Feet Treatment


Jaydee Vykoukal, PT, DPT
Jaydee Vykoukal, PT, DPT

JayDee Vykoukal is a Doctor of Physical Therapy, owner of the healthy habit platform Health Means Wealth, and freelance medical writer. She loves traveling and spending time with her family in nature. Her passion is helping others continue to participate in the activities they love through education and proper exercise.

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