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Flat Foot
(Pes Planus, Pes Planovalgus, “Fallen Arches”)

Definition:
A flat foot occurs when the normal arch is lost and is often associated with ankles that are angled outwards.

Twenty percent of adults have flat feet, and nearly all babies are born without the normal adult arch. Most flat feet are “flexible,” cause no problems, and do not require treatment. A third of them are “rigid,” produce symptoms, and are best treated. Rigid flat feet that need treatment can be identified by symptoms and by examination of the foot.

Causes:
Flat feet are the mildest of many developmental (congenital) problems of the feet the causes of which are not known. Lax joints (being “double jointed”) tend to run in families and produce flat feet along with unusual flexibility of other joints. Occasionally they result from a ruptured ankle tendon, a foot injury, cerebral palsy, spina bifida, or muscular dystrophy.

Risk Factors:
The following factors increase your chances of developing flat feet:
  • Familial tendency
  • Foot injuries
  • Diseases that cause muscle imbalance, such as cerebral palsy, spina bifida, or muscular dystrophy
Symptoms:
If you experience any of these symptoms do not assume it is due to flat feet. These symptoms can be due to many types of foot problems including ill-fitting shoes. If you suffer from any one of them, see your physician or podiatrist.
  • Pain
  • Calluses or redness
  • A stiff foot
  • Weakness or numbness of the foot
  • Rapid wearing out of shoes
  • Worn shoes lean towards each other
  • Other evidence, such as difficulty running, that indicates the foot is having trouble doing its job
Diagnosis:
Your doctor will ask about your symptoms and medical history, and perform a physical exam. If the flat foot is fixed and symptomatic, you will be referred to an orthopedic surgeon for possible surgical correction.

If either of these tests are positive, the flat foot is flexible and unlikely to need Treatment:

  • The arch appears when standing on tiptoe
  • The ankle can be flexed at least 15° up from perpendicular to the lower leg

Treatment:
Talk with your doctor about the best treatment plan for you. Treatment options include the following:

Physical therapy, exercises, and orthotics
If you have mild symptoms, certain exercises, physical therapy, and shoe inserts may relieve the discomfort. A well-fitting pair of shoes may be all that is needed. Flat feet due to nerve or muscle disease may need special braces.

Surgery
For rigid flat feet a surgical procedure can create a satisfactory arch.

Prevention:
To help reduce your chances of getting flat feet, take the following steps:
  • Wear well-fitted shoes with adequate arch support.
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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