Flat Feet: Symptoms, Causes, Diagnosis, and Treatment

Having flat feet, also known as flatfoot, is a condition where one or both feet have little to no arch. When you stand, the pads of the feet press into the ground. Typically, you can’t see an arch in the foot, though sometimes the arch appears when you lift the foot.

All babies have flat feet at birth. Arches typically form by age 6. About two out of 10 children still have flat feet as adults. Some adults have arches that collapse. This condition, fallen arches, is another term for flatfoot.

Flat feet aren’t a problem for most people. If flat feet cause pain or other problems, treatments can help.

Flat Feet (Flatfoot)

What are the types of flat feet?

Flat feet can pose problems whether they persist after childhood or develop in adulthood. The types of flatfoot include:

Flexible: Flexible flat feet are the most common. You can see the arches in the feet when you aren’t standing. The arches disappear when you put weight on the feet. Flexible flatfoot comes on during childhood or the teen years. It affects both feet and gradually gets worse with age. Tendons and ligaments in the arches of the feet can stretch, tear and swell.
Rigid: A person with rigid flat feet has no arches when standing (putting weight on the feet) or sitting (no weight on the feet). This condition often develops during the teen years and gets worse with age. Your feet may feel painful. It can be difficult to flex the feet up or down or move them side-to-side. Flatfoot may affect one foot or both.
Adult-acquired (fallen arch): With an adult-acquired flat foot (fallen arch), the foot's arch unexpectedly drops or collapses. The fallen arch causes the foot to turn outward and can be painful. The problem may affect only one foot. The most common cause is inflammation or a tear in the leg tendon (posterior tibial tendon) that supports the arch.
Vertical talus: Some babies have a birth defect (congenital disability) called vertical talus that prevents arches from forming. The talus bone in the ankle is in the wrong position. The bottom of the foot resembles the bottom of a rocking chair. Vertical talus is also called rocker-bottom foot.

What causes flat feet?

Having flat feet may be in your genes. As a child ages, arches form in the feet. Some people have high arches, while others have very low or nearly absent arches, causing flat feet.

Some people develop flat feet later in life. The condition sometimes runs in families. And certain problems increase your risk of flat feet, including:

Achille’s tendon injuries.
Broken bones.
Cerebral palsy.
Diabetes.
Down syndrome.
High blood pressure.
Obesity.
Pregnancy.
Rheumatoid arthritis.

What are the symptoms of flat feet?

Many people with flat feet don’t experience pain or other problems. But certain types of flatfoot can be painful. Symptoms may include:

Leg cramps.
Muscle pain (aching or fatigue) in the foot or leg.
Pain in the arch, ankle, heel or outside of the foot.
Pain when walking or changes in your gait (how you walk).
Toe drift (front part of the foot and toes point outward).

How are flat feet diagnosed?

Your healthcare provider can make a diagnosis by assessing symptoms and evaluating how your arches look when you stand, sit and walk. You may get X-rays to look at bone structure.

How are flat feet managed or treated?

Many people with flat feet don’t have significant problems or need treatment. Your healthcare provider may recommend nonsurgical treatments if you experience foot pain, stiffness or other issues. Rarely, people need surgery to fix rigid flat feet or problems with bones or tendons.

Treatments include:

Nonsteroidal anti-inflammatory drugs (NSAIDs), rest and ice to ease inflammation and pain.
Physical therapies to stretch and strengthen tight tendons and muscles, improving flexibility and mobility.
Supportive devices like foot orthotics, foot or leg braces and custom-made shoes.

How can I prevent flat feet?

Often, there isn’t anything you can do to prevent flat feet. Staying at a healthy weight may ease pain from flat feet.

What is the prognosis (outlook) for people who have flat feet?

Most people with flat feet get symptom relief with nonsurgical treatments. Some people don’t need any treatment. Flat feet may increase your risk of certain problems like: