Flat Foot

What are flat feet?

You have flatfeet when the arches on the inside of your feet are flattened, allowing the entire soles of your feet to touch the floor when you stand up.

A common and usually painless condition, flatfeet can occur when the arches don't develop during childhood. In other cases, flatfeet develop after an injury or from the simple wear-and-tear stresses of age.

Flatfeet can sometimes contribute to problems in your ankles and knees because the condition can alter the alignment of your legs. If you aren't having pain, no treatment is usually necessary for flatfeet.

What causes flat feet?

A flat foot is normal in infants and toddlers, because the foot's arch hasn't yet developed. Most people's arches develop throughout childhood, but some people never develop arches. This is a normal variation in foot type, and people without arches may or may not have problems.

Some children have flexible flatfoot, in which the arch is visible when the child is sitting or standing on tiptoes, but disappears when the child stands. Most children outgrow flexible flatfoot without problems.

Arches can also fall over time. Years of wear and tear can weaken the tendon that runs along the inside of your ankle and helps support your arch.

In many people, that is just the shape the foot is. It may run in the family, and both feet are usually much the same and reasonably supple.

Will my children have flat feet if I have them?

Possibly. It depends on why your feet are flat. However, most flat feet are just shaped that way or are mobile over-pronated feet in people with relatively lax joints. Both of these tend to run in families.

What are the symptoms of flat feet?

Usually none! Some people with flat feet get aching in the arch, around the ankle or down the outer side of the foot, but all these can occur in people with "normal" arches too. People with very over-pronated feet tend to wear shoes out very quickly.

When should I consult professional help?

Most flat feet cause no trouble and do not need treatment. You may consider consulting your GP if:

What can be done about flat feet?

In most cases, no treatment is needed as the flat feet cause no trouble. Most people whose flat feet ache feel better in well-fitted shoes: sometimes an extra-broad fitting helps. If you have troublesome mobile over-pronated feet, an insole, which prevents your feet rolling over so much, can help a lot. This would normally be provided by a chiropodist.

Children who have an abnormal foot because it has not developed properly may need an operation to straighten the foot or to separate fused bones. These are rare causes of flat foot in children: most children have mobile flat feet which need no treatment, or occasionally an insole because of pain or shoe wear.

A flat foot due to a ruptured tendon or arthritis may be treated with pain-killers and an insole in the first instance. Some of these people will need an operation to straighten their foot.

Should children wear insoles to correct or prevent deterioration of their flat feet?

It used to be thought that flat feet in children should be treated in special shoes, insoles or callipers to stop problems developing in later life. We now know that this was wrong. Studies showed that children treated in this way end up the same as similar children who are not treated, and the child often refuses to wear the shoes, insoles or callipers. There is no evidence that treating flat feet in childhood prevents problems in adult life and most of these children will not get problems as adults even if left untreated.

The only reason to treat your child's feet would be if they cause a lot of pain or wear out their shoes very quickly. In this case, modern practice would usually be to advise an insole that fits inside the shoes.