What are Flat Feet?

Flat feet, also known as fallen arches, is a foot posture in which the inner arch of the foot has collapsed. As a result, the bottom of the foot is in complete contact with the floor. This condition can occur in one or both feet.

The Anatomy of the Foot

Each foot has 26 different bones, 33 joints, and over 100 muscles, tendons and ligaments. The arch of the foot gives spring to the step and determines how someone walks. Arches help distribute a person’s body weight between the feet and legs. Feet need to be both sturdy and flexible to adapt to different tasks and stresses.

What Causes Flat Feet?

There are many reasons why a person may develop flat feet. Flat feet can develop if a person is obese, diabetic, or even pregnant. Other causes include:

  • Genetics
  • Weak arches
  • Foot injury
  • Ankle injury
  • Arthritis or rheumatoid arthritis
  • Posterior tibial tendon dysfunction, damage or rupture
  • Nervous system or muscle diseases (cerebral palsy, muscular dystrophy or spina bifida)
  • Tarsal coalition (when the bones of the foot fuse together)
  • Tendonitis

Detecting Early Signs of Flat Feet

It is difficult to be able to detect the onset of falling arches even through X-rays. Yet some common symptoms can help to diagnose flat feet, including chronic pain, discomfort or fatigue in the foot, lower leg and/or ankle. If you have any of these symptoms you should see your doctor at the earliest opportunity.

Does My Child Have Flat Feet?

In the early stages of a child’s life, it may seem as if he or she has flat feet. The arch is there, but the child’s feet are still forming. As your child grows the arch will appear as normal. However, if your child’s feet remain flat, you should contact your doctor to rule out incorrect bone development or another disease such as spina bifida.

Diagnosing Flat Feet or Fallen Arches

Diagnosing flat feet can be difficult if the patient does not experience pain or any other symptoms. However, if any of the following conditions arise, you should consult with an orthopedic physician.

  • Pain in the feet, ankles or lower limbs
  • Symptoms do not improve with proper shoe support
  • The feet feel stiff or difficult to maneuver
  • One or both feet are becoming flatter
  • Fallen arches have developed

An orthopedic physician can diagnose flat feet by watching how the patient stands and walks, in addition to examining the feet. In some cases, the physician may suggest an X-ray, CT scan, or MRI scan to give a diagnosis.

Symptoms of Flat Feet and Fallen Arches

Flat feet may not cause any problems for some people, but some of the symptoms can include:

Basic Treatment for Flat Feet and Fallen Arches

There are a few treatment options to consider before surgery to correct flat feet. Some of these treatment options are:

  • Supportive shoes (insoles or orthotics to increase support)
  • Pain management medication
  • Physiotherapy or stretching exercises
  • Weight loss (if overweight)

Complications of Flat Feet or Fallen Arches

A patient with other foot, ankle or lower leg issues may find that flat feet make their symptoms worse. Fallen arches can affect the alignment of a person’s body as they are standing, which can increase the chance of developing other issues and pain in the hips, knees, and ankles. Some complications to flat feet include:

  • Achilles tendonitis
  • Arthritis in the ankle(s)
  • Arthritis in the foot or feet
  • Bunions
  • Hammertoes
  • Plantar fasciitis
  • Posterior tibial tendonitis
  • Shin splints

Are There Exercises to Help Correct Flat Feet?

There are a few different exercises that can help reduce or prevent fallen arches. Here are some exercises recommended by physical therapists:

  • Heel cord stretching: Heel cord stretching aims to stretch and lengthen the Achilles tendon and posterior calf muscles.
    • Directions: (Twice daily)
      • Face a wall while standing, place one hand on the wall at eye level
      • Place the leg that needs to be stretched one step behind the other leg, with the heel planted on the ground
      • Bend the knee of the front leg until you feel a stretch in the back of your leg
      • Hold for 30 seconds, and repeat (10 sets)
  • Golf Ball Roll – Items needed: Golf ball (or therapy ball) and a chair
    •  Directions:
      • Sit on the chair with your feet placed firmly on the ground
      • Place the golf ball under the first foot
      • Roll the golf ball back and forth under the arch of the foot for two minutes
      • Repeat the steps with the second foot

For more exercises, please visit the American Academy of Orthopedic Surgeons, “Foot and Ankle Conditioning Program”.