What is Flat Feet? Symptoms, Causes, & Treatment

Flat feet means your foot arches are lower than usual or completely absent. When you stand, the entire sole of your foot touches the ground instead of having a curved space underneath.

This condition is incredibly common and affects millions of people worldwide. Many people with flat feet live completely normal, active lives without any problems. However, some may experience discomfort or pain that benefits from proper care and attention.

What are flat feet?

Flat feet occur when the arch on the inside of your foot is flattened or never fully develops. Think of your foot like a bridge - normally there's a curved space between your heel and the ball of your foot that doesn't touch the ground when you stand.

With flat feet, this natural curve is reduced or missing entirely. Your foot may appear to lie completely flat against the floor. This happens because the tendons and ligaments that normally hold your arch in place are either looser than usual or structured differently.

There are two main types you should know about. Flexible flat feet means your arch appears when you're not putting weight on your foot, but flattens when you stand. Rigid flat feet means there's no arch whether you're standing or sitting, and this type is less common.

What are the symptoms of flat feet?

Many people with flat feet have no symptoms at all and only discover the condition during a routine examination. When symptoms do occur, they typically develop gradually and may come and go depending on your activity level.

Here are the most common signs you might notice:

• Foot pain or aching, especially in the arch area or heel
• Swelling along the inside of your ankle
• Difficulty standing on your toes
• Pain that worsens with activity and improves with rest
• Lower leg or knee pain
• Stiffness in one or both feet

Some people also experience back pain or hip discomfort. This happens because flat feet can change how you walk and distribute weight, which affects your entire body's alignment over time.

Less commonly, you might notice that your shoes wear unevenly or that finding comfortable footwear becomes challenging. These symptoms usually indicate that your flat feet are affecting how you move and may benefit from professional evaluation.

What are the types of flat feet?

Understanding the different types helps explain why some people have symptoms while others don't. The main distinction is between flexible and rigid flat feet, but there are several variations to consider.

Flexible flat feet is the most common type. Your arch disappears when you put weight on your foot but returns when you lift it up or stand on your toes. This type often causes fewer problems and may not require treatment unless symptoms develop.

Rigid flat feet means your foot has no arch in any position. This type is more likely to cause pain and functional problems because the foot can't adapt and absorb shock as effectively during walking or running.

Adult-acquired flat foot is another important category. This develops later in life, often due to injury or wear and tear of the tendons that support your arch. It typically affects one foot more than the other and may progress over time.

Congenital flat feet means you're born with the condition. Most babies and young children naturally have flat feet that develop arches as they grow. However, some people's arches never fully form, which is completely normal for them.

What causes flat feet?

Flat feet develop for many different reasons, and understanding the cause can help guide the best treatment approach. Most cases are simply a normal variation in how feet are shaped, much like how people have different eye colors or heights.

The most common causes include:

• Genetics - flat feet often run in families
• Normal development - some children's arches never fully develop
• Injury to the posterior tibial tendon (the main tendon supporting your arch)
• Arthritis, particularly rheumatoid arthritis
• Nervous system conditions affecting muscle control
• Diabetes, which can affect tendon strength over time

Pregnancy can also contribute to flat feet development. The hormones that help prepare your body for childbirth can loosen ligaments throughout your body, including those in your feet. Combined with weight gain, this sometimes leads to permanent arch changes.

Age plays a role too. As we get older, the tendons and ligaments that support our arches naturally become less elastic. Years of wear and tear can gradually flatten arches that were normal in younger years.

In rare cases, flat feet result from tarsal coalition, a condition where two or more bones in the foot are abnormally connected. This typically becomes apparent during teenage years when the bones mature and the connection becomes rigid.

When to see a doctor for flat feet?

You should consider seeing a healthcare provider if your flat feet are causing pain or interfering with your daily activities. Many people live their entire lives with flat feet and never need medical attention, but persistent discomfort deserves evaluation.

Schedule an appointment if you experience ongoing foot, ankle, or lower leg pain that doesn't improve with rest. Pain that worsens with activity or makes it difficult to walk, exercise, or wear shoes comfortably warrants professional assessment.

Sudden changes in your foot shape or the development of flat feet in adulthood should be evaluated promptly. This could indicate an injury or underlying condition that needs treatment to prevent further problems.

You should also seek care if you notice significant swelling, stiffness, or if one foot appears different from the other. These signs might suggest an injury or inflammatory condition affecting the structures that support your arch.

For children, it's worth discussing flat feet with your pediatrician if your child complains of foot pain, seems to tire easily during physical activities, or if you notice their feet look very different from other children their age.

What are the risk factors for flat feet?

Several factors can increase your likelihood of developing flat feet or experiencing symptoms if you already have them. Understanding these risk factors helps you make informed decisions about prevention and care.

The most significant risk factors include:

• Family history - genetics play a major role in foot structure
• Age - arches may flatten over time due to normal wear and tear
• Obesity - extra weight puts additional stress on foot structures
• Pregnancy - hormonal changes and weight gain affect ligaments
• Diabetes - can weaken tendons and ligaments over time
• High blood pressure - may affect circulation and tissue health

Certain activities and occupations also increase risk. Jobs that require prolonged standing or walking on hard surfaces can contribute to arch problems over time. Athletes who participate in high-impact sports may be more prone to tendon injuries that affect arch support.

Previous foot or ankle injuries create additional risk. Even if an injury heals completely, it may leave your foot structures slightly weakened or altered in ways that affect arch support years later.

Some medical conditions rarely associated with flat feet include cerebral palsy, muscular dystrophy, and spina bifida. These conditions affect muscle control and strength, which can impact the foot's ability to maintain its normal arch structure.

What are the possible complications of flat feet?

Most people with flat feet experience no complications and live completely normal lives. However, when problems do occur, they typically develop gradually and are often manageable with proper care and attention.

The most common complications you might encounter include:

• Chronic foot and ankle pain that interferes with daily activities
• Plantar fasciitis - inflammation of the tissue along the bottom of your foot
• Achilles tendinitis - irritation of the large tendon at the back of your ankle
• Shin splints - pain along the front or inside of your lower legs
• Knee, hip, or lower back pain due to altered walking patterns
• Arthritis in the foot and ankle joints from increased stress

These complications happen because flat feet can change how you walk and distribute weight. Over time, this altered movement pattern can stress other parts of your body in ways they weren't designed to handle.

Rarely, severe flat feet may lead to more significant problems like posterior tibial tendon dysfunction. This condition involves progressive weakening and tearing of the main tendon that supports your arch, potentially leading to an increasingly deformed foot shape.

The good news is that most complications are preventable or treatable when caught early. Regular monitoring and appropriate interventions can help you maintain good foot function and prevent minor issues from becoming major problems.

How can flat feet be prevented?

While you can't prevent flat feet that are present from birth or due to genetic factors, you can take steps to maintain healthy feet and reduce your risk of developing symptoms or complications.

Maintaining a healthy weight is one of the most important preventive measures. Extra pounds put additional stress on the structures that support your arches, potentially accelerating wear and tear over time.

Choose supportive footwear whenever possible. Shoes with good arch support, proper cushioning, and appropriate fit can help reduce stress on your feet during daily activities. Avoid walking barefoot on hard surfaces for extended periods.

Regular foot exercises can help strengthen the muscles and tendons that support your arches. Simple activities like picking up marbles with your toes or doing calf raises can maintain flexibility and strength in your feet and lower legs.

Pay attention to early warning signs like occasional foot pain or fatigue. Addressing minor discomfort promptly with rest, appropriate footwear, or professional evaluation can prevent more serious problems from developing.

If you participate in sports or high-impact activities, make sure you're using proper technique and appropriate equipment. Gradually increase training intensity rather than making sudden changes that could stress your feet beyond their capacity.

How are flat feet diagnosed?

Diagnosing flat feet usually begins with a simple visual examination and discussion of your symptoms. Your healthcare provider can often identify flat feet just by looking at your feet and watching how you walk.

The evaluation typically starts with you standing barefoot while your doctor observes your foot shape from different angles. They'll look at your feet from behind to see if your heel bone tilts inward and from the side to assess your arch height.

Your provider will ask you to perform simple movements like standing on your toes or walking on your heels. These tests help determine whether you have flexible or rigid flat feet and assess how well your foot structures are functioning.

If more detailed information is needed, imaging tests might be recommended. X-rays can show the bone structure of your feet and reveal any abnormalities or signs of arthritis that might be contributing to your symptoms.

In some cases, your doctor might order an MRI or CT scan. These more detailed imaging studies can evaluate the soft tissues like tendons and ligaments that support your arch, helping identify specific injuries or degenerative changes.

A footprint test or computerized foot analysis might also be used. These tools can provide precise measurements of your foot shape and pressure distribution, helping guide treatment decisions if needed.

What is the treatment for flat feet?

Treatment for flat feet focuses on managing symptoms and preventing complications rather than changing your foot structure. Many people with flat feet need no treatment at all, while others benefit from simple, conservative approaches.

The first line of treatment typically includes rest and activity modification. If your flat feet cause pain, taking breaks from activities that worsen symptoms can provide significant relief and allow inflamed tissues to heal.

Supportive footwear and orthotic devices are often very effective. Over-the-counter arch supports or custom-made orthotics can provide the support your feet need and redistribute pressure more evenly across your foot.

Common treatment options include:

• Arch support insoles or custom orthotics
• Supportive athletic shoes or walking shoes
• Physical therapy exercises to strengthen supporting muscles
• Anti-inflammatory medications for pain and swelling
• Ice therapy after activities that cause discomfort
• Stretching exercises for tight calf muscles and Achilles tendons

Physical therapy can be particularly helpful for teaching you exercises that strengthen the muscles supporting your arches and improve your overall foot function. Your therapist can also help you learn proper walking techniques to reduce stress on your feet.

Surgery is rarely needed for flat feet and is typically considered only when conservative treatments haven't helped and symptoms significantly interfere with your quality of life. Surgical options might include tendon transfers, bone fusions, or procedures to create an artificial arch support.

How to manage flat feet at home?

Home management of flat feet focuses on reducing discomfort and supporting your feet during daily activities. Simple strategies can often provide significant relief and help prevent symptoms from worsening.

Start with proper footwear selection. Choose shoes with good arch support, adequate cushioning, and a proper fit. Avoid high heels, flip-flops, or completely flat shoes that provide no support for extended periods.

Ice therapy can help when your feet feel sore or swollen. Apply ice wrapped in a thin towel to the painful area for 15-20 minutes at a time, especially after activities that aggravate your symptoms.

Gentle stretching exercises can maintain flexibility in your feet and lower legs. Focus on stretching your calf muscles and Achilles tendons, as tightness in these areas can worsen flat foot symptoms.

Consider these helpful home strategies:

• Use over-the-counter arch supports in your shoes
• Perform toe exercises like picking up objects or spreading your toes
• Roll a tennis ball under your foot to massage the arch area
• Elevate your feet when resting to reduce swelling
• Maintain a healthy weight to reduce stress on your feet
• Alternate between different pairs of supportive shoes

Pay attention to surfaces you walk on regularly. When possible, choose softer surfaces like grass or rubberized tracks over concrete or asphalt for exercise and recreational activities.

Keep a symptom diary to identify activities or situations that worsen your discomfort. This information can help you make informed decisions about activity modifications and when to seek additional help.

How should you prepare for your doctor appointment?

Preparing for your appointment helps ensure you get the most benefit from your time with your healthcare provider. Gathering relevant information beforehand allows for a more focused and productive discussion.

Before your visit, make a list of your symptoms including when they started, what makes them better or worse, and how they affect your daily activities. Be specific about the type and location of any pain you experience.

Bring a list of all medications and supplements you're currently taking. Some medications can affect tendon health or cause swelling that might be relevant to your foot symptoms.

Consider bringing the shoes you wear most often to your appointment. Your doctor can examine wear patterns that might provide clues about how your flat feet affect your walking and which treatments might be most helpful.

Prepare these important details to share:

• Family history of foot problems or flat feet
• Previous foot or ankle injuries, even if they seemed minor
• Activities or sports that worsen your symptoms
• What treatments you've already tried and their effectiveness
• Questions about specific activities you'd like to continue
• Concerns about long-term outcomes or complications

Write down your questions in advance so you don't forget to ask them during the appointment. Common questions might include whether your condition will worsen over time, what activities you should avoid, or when you might need to seek additional care.

If possible, wear or bring loose-fitting pants that can be easily rolled up. Your doctor will need to examine your feet, ankles, and lower legs, so comfortable clothing that allows easy access will make the examination more efficient.

What's the key takeaway about flat feet?

The most important thing to understand about flat feet is that it's a common, often harmless condition that millions of people live with successfully. Having flat feet doesn't automatically mean you'll have problems or need treatment.

Many people discover they have flat feet only during routine examinations and never experience any symptoms. For those who do have discomfort, effective treatments are available that can provide significant relief and help you maintain an active lifestyle.

The key is paying attention to your body and seeking help when symptoms interfere with your daily activities. Early intervention with simple measures like supportive footwear and appropriate exercises can often prevent minor issues from becoming major problems.

Remember that flat feet is just one variation in normal human anatomy. With proper care and attention when needed, you can expect to participate fully in work, sports, and recreational activities throughout your life.

Focus on maintaining overall foot health through good footwear choices, appropriate exercise, and prompt attention to any persistent pain or discomfort. Your feet carry you through life, and with the right approach, flat feet doesn't have to limit where they take you.