Flat feet (also called pes planus or fallen arches) is a formal reference to a medical condition in which the arch of the foot collapses, with the entire soleof the foot coming into complete or near-complete contact with the ground. In some individuals (an estimated 20–30% of the general population) the arch simply never develops in one foot (unilaterally) or both feet (bilaterally).
Three studies of military recruits have shown no evidence of later increased injury, or foot problems, due to flat feet, in a population of people who reach military service age without prior foot problems. However, these studies cannot be used to judge possible future damage from this condition when diagnosed at younger ages.
They also cannot be applied to persons whose flat feet are associated with foot symptoms, or certain symptoms in other parts of the body (such as the leg or back) possibly referable to the foot.
People who have flat feet rarely have symptoms or problems.
Some people may have pain because of:
- Changes in work environment.
- Minor injury.
- Sudden weight gain.
- Excessive standing, walking, jumping, or running.
- Poorly fitted footwear.
Children sometimes have foot discomfort and leg aches associated with flat-footedness.
Flat feet can run in families.
If a flat foot did not exist before but develops later in life, this can be due to:
- a ruptured tendon.
- a disease of the nervous system or muscles, such as cerebral palsy, spina bifida or muscular dystrophy, where the muscles are weakened.
Very rarely, the flat foot shape is caused by a condition called tarsal coalition. This results in the bones of the foot joining together abnormally, and causes stiff, flat feet. This condition is usually obvious, and normally diagnosed in childhood.
Painful flat feet in children may be caused by a condition called tarsal coalition. Tarsal coalition is a condition where two or more of the bones in the foot fuse together, limiting motion and often leading to a flat foot.
Flat feet can also be caused by fallen arches. Years of wear and tear can weaken the tendon that is responsible for shaping the arch. Fallen arches can also be caused by injury such as inflammation of the tendons in the foot.
Treatment in adults generally consists of wearing spacious, comfortable shoes with good arch support. Your doctor may recommend padding for the heel (heel cup) or orthotic shoe devices, which are molded pieces of rubber, leather, metal, plastic, or other synthetic material that are inserted into a shoe. They balance the foot in a neutral position and cushion the foot from excessive pounding.
For children, treatment using corrective shoes or inserts is rarely needed, as the arch usually develops normally by age 5.
Surgery is rarely needed.
You may be able to relieve heel pain by stretching tight calf muscles. See a picture a calf stretch exercise.
- Stand about 1 ft (30 cm) from a wall and place the palms of both hands against the wall at chest level.
- Step back with one foot, keeping that leg straight at the knee, and both feet flat on the floor. Your feet should point directly at the wall or slightly in toward the center of your body. Keep the knee of the leg nearest the wall centered over the ankle.
- Bend your other (front) leg at the knee, and press the wall with both hands until you feel a gentle stretch on your back leg (calf muscle).
- Hold for a count of 10 (increasing the count to 30 or longer as you continue over several weeks). Switch legs and repeat. Do this 2 to 4 times a day.
Foot-strengthening exercises done with a towel and weights. See a picture of atowel curl exercise.
- Place a towel on the floor, and sit down in a chair in front of it with both feet resting flat on the towel at one end.
- Grip the towel with the toes of one foot (keep your heel on the floor and use your other foot to anchor the towel). Curl your toes to pull the towel toward you.
- Repeat with the other foot. To increase strength, later use 3 lb (1.5 kg) to 5 lb (2.5 kg) weights (such as a large can of fruit or vegetables) on the other end of the towel.
Foot-stretching exercises done with a towel. See a picture of a towel stretch exercise.
- Sit down on the floor or a mat with your feet stretched out in front of you.
- Roll up a towel lengthwise and then loop it over one foot (around the ball of your foot).
- Take one end of the towel in either hand and gently pull the towel towards your body to stretch the front of your foot. Repeat with the other foot.
Some people — especially competitive athletes, people who want to return to a heavy sports program, or people who are highly motivated — may choose more intensive strengthening and flexibility programs. A physical therapist or trainer can help supervise a program recommended by your sports medicine specialist or a foot specialist, such as an orthopedist or podiatrist.
Treatment with nonsteroidal anti-inflammatory drugs (NSAIDs), heat, or massage may help with foot pain and leg discomfort. If flatfoot is related to another condition, surgery or other treatment may be needed.