More than 3 million people are diagnosed with flat feet every year in the United States. Though this condition is usually painless, developing flat feet as an adult can lead to debilitating pain that inhibits the quality of life for some. Fortunately, non-invasive treatments are available to help those with flat feet support their natural arches and get back to the activities they love.

What are flat feet?

A person has flat feet when the arches on the inside of the feet are low enough to touch the floor when standing. Most cases of flat feet are painless and require no treatment. For some, especially those who acquire flat feet as adults, pain and mobility issues may result.

Symptoms of flat feet

Patients with flat feet are most likely to notice that their feet do not look like the feet of their friends, which have a higher arch in the middle of the foot. Sometimes a giveaway of having flat feet is walking next to a friend on the beach. The flat-footed person’s footprint will leave an impression in the sand from the toes to the heel on both sides of the feet. The person with a more average arch will leave a footprint that has a definite C shape, with a section of the foot not touching the sand where the arch lies.

Most people do not experience any symptoms related to their flat feet. But people who do experience flat foot symptoms may notice:

  • Pain in the arch of the foot
  • Pain in the heel of the foot
  • Swelling along the inside of the ankle

What causes flat feet?

Flat feet typically develop when the arch of the foot does not properly develop during childhood. Children are born with flat feet, and the arch develops throughout childhood growth.  For patients with flat feet, the arch never develops. This is not a cause for alarm, but rather a natural variation in the shape of the human foot. Unless flat feet are causing problems, no treatment is necessary.

Flat feet can also develop during adulthood when a healthy arch falls and becomes flat. This can happen when the tendon that supports the arch of the foot is weakened through years of wear and tear. When flat feet develop during adulthood, this is referred to as having “fallen arches.” Adult-acquired flatfoot can cause significant pain and be debilitating in some cases.

Adult-acquired flatfoot is often caused by posterior tibial tendon dysfunction. The posterior tibial tendon’s job is to support the arch of the foot during movement. This tendon is located on the inside of the lower leg from the calf muscle to the inside of the foot. If the posterior tibial tendon becomes damaged or inflamed, it may no longer be able to support the arch of the foot, leading to flat feet.

Risk factors for developing fallen arches include:

Being overweight – Extra weight puts additional stress on the feet and tendons and can lead to a flattening of the arch.

Injury to the foot or ankle – Damage to the ligaments and tendons of the feet can lead to flat feet.

Rheumatoid arthritis – Inflammation that attacks the cartilage can cause the foot to lose its arch.

Aging – Over time, the arch can experience wear and tear that gradually flattens it.

Diabetes – Diabetic neuropathy may prevent a patient from noticing an injury to the foot that can lead to fallen arches.

Being pregnant – The excess weight associated with pregnancy can cause feet to flatten.

Being female – Women are more likely than men to develop adult acquired flat feet. This may be due to the prevalence of non-supportive women’s shoes.

Participating in athletics – Athletes are more likely to put a strain on their feet as well as acquire damage to the tendons and ligaments in the foot that support the arch.

Diagnosing flat feet

If flat feet or fallen arches are causing problems like pain and swelling, a physician will do a physical examination of the feet as well as order imaging tests to better visualize the inner mechanics of the feet. Tests that may be ordered to diagnose flat feet include:

X-rays – An x-ray will provide images of the bones in the feet and is helpful in determining if the fallen arches are due to arthritis.

CT scan – A CT scan provides more detail than an X-ray and may be used if X-rays are insufficient at providing diagnostic data about the feet.

Ultrasound – Ultrasounds are helpful for visualizing issues of the soft tissues of the feet such as tendons.

MRI – An MRI provides the most detailed image of the inner structures of the foot.

Treatment for flat feet and fallen arches

If flat feet or fallen arches are causing problems, many non-invasive treatments are available to support the arch of the foot and eliminate pain. Treatments for fallen arches and flat feet include:

Arch supports – Arch supports are a type of orthotic device worn as an insert in shoes. Arch supports lift and support the arch into a healthy position. Arch supports do not cure flat feet, but they can reduce symptoms such as pain.

Stretching exercises – When flat feet are caused by a shortened Achilles tendon, stretching exercises can help.

Orthotic shoes – Wearing shoes with proper arch support can help take the pressure off the arch and reduce pain.

Physical therapy – Flat feet caused by overuse or improper form during activities may be helped by learning proper form from a physical therapist.

Surgery for flat feet

Surgery is usually not necessary for the treatment of flat feet. Surgery to correct related health issues such as a damaged tendon may be part of an overall plan to treat fallen arches.

How to prevent fallen arches

Protecting the arch of the foot is paramount when preventing fallen arches. To prevent fallen arches, we recommend:

  • Wearing the right shoes – Shoes that provide adequate arch support and cushioning help to reduce strain on the arch.
  • Maintaining a healthy weight – Obesity can cause fallen arches because of the excess weight pressing down on the arch of the foot with each step.
  • Take it easy – If certain activities cause pain in the arch of the foot, approach those activities with caution. Do not “power through” once pain starts to develop in the foot.

Looking for a second opinion about your fallen arches?

Schedule your appointment today with one of our board-certified flat feet physicians and get the answers you need to support the pain-free movement.