The Problems With Flat Feet: Causes, Symptoms, and Effective Solutions

Flat feet, also known as pes planus, occur when the arches of the feet collapse, causing the entire sole to make contact with the ground. While some people with flat feet experience no issues, others suffer from pain, instability, and postural problems that can affect the entire body.

In this blog, we’ll explore the causes of flat feet, the potential problems they can lead to, and the best treatment options to relieve pain and improve function.

What Are Flat Feet?

Flat feet occur when the foot arch does not develop properly or collapses over time. This can be flexible (arches appear when not weight-bearing) or rigid (arches remain flat even when off the ground).

Flat feet can be:

✅ Congenital (Present From Birth) – Some people are born with flat feet due to genetics.
✅ Acquired (Develop Later in Life) – Arches may collapse due to injury, ageing, or other conditions.

What Causes Flat Feet?

Several factors contribute to flat feet, including:

1. Genetics

• If your parents have flat feet, you are more likely to have them as well.

2. Weak Foot Muscles

• Poor foot strength can contribute to arch collapse over time.

3. Overpronation (Excessive Foot Rolling Inward)

• Flat feet often lead to overpronation, causing uneven weight distribution.

4. Injury or Trauma

• A broken bone, torn tendon, or sprained ligament can weaken foot structure.

5. Ageing & Wear-and-Tear

• Adult-acquired flatfoot occurs when the arch collapses due to weakened tendons, especially the posterior tibial tendon.

6. Obesity

• Excess weight puts additional strain on the arches, contributing to flattening.

7. Pregnancy

• Hormonal changes and weight gain can temporarily weaken ligaments, leading to flat feet.

8. Neurological or Muscular Disorders

• Conditions like cerebral palsy, spina bifida, or muscular dystrophy can result in flat feet.

Common Problems Caused by Flat Feet

While some individuals experience no issues, many people with flat feet develop pain, instability, and alignment problems.

1. Foot Pain & Fatigue

• Plantar Fasciitis: The lack of arch support strains the plantar fascia, leading to heel pain.
• Arch Pain: The collapsed arch cannot absorb shock properly, causing discomfort.
• Metatarsalgia: Pain in the ball of the foot due to uneven pressure distribution.

2. Knee Pain & Joint Misalignment

• Flat feet alter leg biomechanics, leading to excessive knee rotation and strain on the joints.
• Common conditions include patellofemoral pain syndrome (runner’s knee) and IT band syndrome.

3. Hip & Lower Back Pain

• Poor foot alignment affects the pelvis and spine, leading to compensatory movements that cause back pain.
• Over time, this can contribute to chronic lower back issues.

4. Ankle Instability & Tendon Problems

• Posterior Tibial Tendon Dysfunction (PTTD): The tendon supporting the arch weakens, worsening flatfoot deformity.
• Achilles Tendonitis: The altered gait pattern increases stress on the Achilles tendon.

5. Bunions & Toe Deformities

• Flat feet can cause bunions, hammertoes, or claw toes due to improper foot mechanics.

6. Balance Issues & Increased Risk of Injury

• Lack of arch support reduces shock absorption, increasing the risk of ankle sprains, shin splints, and stress fractures.

How to Diagnose Flat Feet

A podiatrist, physiotherapist, or orthopaedic specialist can diagnose flat feet using:

• Physical Examination: Checking foot structure, arch height, and gait.
• Wet Foot Test: Leaving a footprint on paper to assess arch collapse.
• Gait Analysis: Observing walking or running patterns for overpronation.
• X-rays or MRI: Used in severe cases to check for joint or tendon damage.

Best Treatment Options for Flat Feet

1. Orthotics for Arch Support

• Custom Orthotics: Designed to provide personalised arch support.
• Over-the-Counter Insoles: Prefabricated options for mild cases.
• Motion Control Shoes: Help stabilise the foot and improve gait mechanics.

2. Strengthening Exercises

• Arch Lifts: Strengthen the foot muscles to support the arch.
• Toe Curls & Short Foot Exercise: Improve foot intrinsic muscle strength.
• Heel Raises: Strengthen the posterior tibial tendon and calf muscles.

3. Stretching Exercises

• Calf Stretch: Reduces Achilles tendon tightness.
• Plantar Fascia Stretch: Helps relieve heel pain.
• Hip & Hamstring Stretches: Improves overall lower body mobility.

4. Physical Therapy

• Corrects gait abnormalities, improves strength, and reduces pain.
• Helps prevent further joint misalignment and compensatory injuries.

5. Footwear Adjustments

• Wear supportive shoes with good arch support.
• Avoid flat, unsupportive shoes (e.g., flip-flops or worn-out sneakers).

6. Weight Management

• Reducing excess weight can decrease strain on the arches.

7. Lifestyle Modifications

• Avoid prolonged standing on hard surfaces.
• Take regular breaks if walking or running long distances.

8. Surgical Options (For Severe Cases)

• If conservative treatments fail, surgery may be needed to correct severe flatfoot deformity.
• Surgical options:
  • Tendon reconstruction
  • Osteotomies (bone realignment)
  • Joint fusion in extreme cases

FAQs About Flat Feet

1. Can flat feet be corrected?

• Flexible flat feet can often be managed with orthotics, strengthening exercises, and supportive footwear.
• Rigid flat feet may require medical intervention if pain persists.

2. Do I need orthotics for flat feet?

• If you have pain, instability, or alignment issues, orthotics can provide essential support and comfort.

3. Are flat feet bad for running?

• Many runners with flat feet perform well with proper footwear and training adjustments.
• However, overpronation increases the risk of injuries like shin splints and knee pain.

4. Will my child’s flat feet improve over time?

• Many children outgrow flat feet as their arches develop naturally.
• If they experience pain or mobility issues, medical assessment is recommended.

5. Can flat feet cause back pain?

• Yes! Misalignment in the feet affects posture and gait, leading to hip and lower back strain.

6. When should I see a doctor about my flat feet?

• If you have persistent pain, swelling, difficulty walking, or worsening foot deformities, seek professional evaluation.

Final Thoughts: Managing Flat Feet for Long-Term Comfort

Flat feet don’t always cause problems, but when they do, they can affect the entire body. The key to managing flat feet is understanding their impact on posture, biomechanics, and movement.

By using proper footwear, orthotics, strengthening exercises, and lifestyle adjustments, you can reduce pain, improve function, and prevent long-term complications.

If you’re experiencing persistent pain or difficulty with movement, consult a podiatrist or physiotherapist to develop a personalised treatment plan.