5 Treatments to Help Flat Feet
Key takeaways:
Flat feet, or pes planus, occurs when the arch of the foot collapses.
It is not always problematic, but for some it can cause pain, weakness, or impaired function.
Exercises and arch support are generally recommended, but some people may need surgery to fix the problem.
Our body parts come in all shapes and sizes, and that includes feet. Some of us have flat feet, while some of us have high arches. Most people are somewhere in the middle. But if you have flat feet, they may be causing you discomfort. If that’s the case, keep reading to learn more about what you can do about it.
What are flat feet?
Flat feet refer to the part of your feet where the arch should be. When the arch is absent or collapsed, the entire foot touches the floor when standing. The medical term is pes planus. It can affect one foot or both feet.
There are two types of pes planus. Flexible pes planus is when the arch is flat while standing but present while not standing or bearing weight. Rigid pes planus means the arch is absent at all times. This type is less common and more difficult to treat.
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Flat feet are common in children, before the arch develops, but are unlikely to cause problems. In adults, flat feet can cause discomfort, pain, and sometimes weakness.
What causes flat feet?
In some cases, the arch never develops in childhood and the feet stay flat. This is thought to be hereditary or congenital. Rigid pes planus is usually due to a problem with the foot bones, called tarsal coalition.
In adult acquired flatfoot (flatfoot is the medical term for the condition), the arch gradually collapses over time. The tendon of a muscle called the posterior tibialis runs behind the inside bone of the ankle and down into the foot. This tendon and other ligaments in the foot become weak, allowing the arch to flatten out.
This type of flatfoot is more common in women and people over 50. Other risk factors include:
Overweight or obesity
Inflammatory diseases
Previous ankle injury
Women can also experience flattening of the arches during pregnancy. This is thought to be due to the increase in weight and more laxity in ligaments.
How do I know if I have flat feet?
Loss of the arch is the biggest sign. When standing, your arch flattens and touches the floor. Your toes can start to point outwards, rather than straight forward. When someone looks at you from behind, it looks like your heel is drifting to the side, rather than in line with your calf and Achilles.
When flat feet start to cause symptoms, they can include:
Pain in your foot, heel, or ankle
Local swelling and tenderness (pain when you push on it)
Trouble standing on the ball of your foot
Feeling of fatigue in the foot or ankle
Difficulty with running, jumping, or similar activities
Weakness, which can lead to ankle sprain
Sometimes flat feet can even lead to knee, hip, or back pain.
5 ways to treat flat feet
If you have flat feet and they’re starting to bother you, there are some things you can try on your own. It’s important to get the advice of a specialist if your pain doesn’t get better or gets worse.
1) Shoes
It’s a good idea to start with shoes that provide good arch support. There is no one “best” shoe, but something that stabilizes your foot is likely better than something without support, such as flip-flops.
2) Exercises
Exercises are intended to strengthen the muscles in the foot, calf, and ankle. Stretching the Achilles tendon is often recommended, too. Physical therapy may be recommended to help you learn the exercises and perform them safely.
3) Orthoses
An orthosis (sometimes referred to as an “orthotic”) is a device designed to assist a biomechanical issue or improve motion. For flat feet, this may include an ankle-foot orthosis, which looks like a brace, or a foot orthosis, which goes in the shoe. Both are meant to support the arch, assist the motion of the foot, and relieve discomfort. Studies show orthoses can help with pain and foot motion.
Shoe orthoses or inserts are either premade or custom-made. It’s OK to start with premade orthoses, as they are generally less expensive. But foot specialists sometimes recommend custom-made orthoses for more severe cases of flatfoot.
4) Immobilization
Sometimes it helps to let your foot, and especially the posterior tibialis tendon, rest. Your healthcare provider may recommend wearing a boot or cutting back on certain activities for a few weeks. If you do this, remember to be gentle with yourself as you come back out of the boot — do your stretches and ease back into activities. You may be advised to use an orthosis after your period of rest.
5) Surgery
If the other treatments don’t help your pain related to flat feet, several surgery options are available. The type of surgery needed usually depends on how flat your feet are and the alignment of the bones according to imaging tests. Surgery can involve realigning the bones or moving tendons and ligaments. It usually requires a long recovery period while being off your feet.
What happens if you don’t treat flat feet?
This depends on the age of the person with flat feet and whether it’s rigid or flexible. In most adults, it can get worse if it’s not treated. This leads to increased pain and impaired function.
There is a bit of controversy about how aggressively children and teens with flat feet should be treated, although orthoses and exercises are usually recommended if they’re having pain. Rigid flatfoot will not get better without surgery.
When should I see a foot doctor?
If you don’t get relief from exercises and arch support, it’s a good idea to get help. You can find a medical doctor trained in foot and ankle disorders (orthopedist) here or a foot specialist (podiatrist) here.
The bottom line
Flat feet can cause pain for some people. Good arch support with shoes and orthoses are often recommended, as well as exercises. Depending on how severe your condition is, surgery may be an option. It’s a good idea to see your healthcare provider or find a specialist if flat feet are causing you trouble.
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