Flatfeet: Causes,Types, Symptoms, Complications, Risks, Diagnosis and Treatment

Illustration of flat feet‬‏


Flatfeet is a condition wherein the arch on the side of the feet are flattened, making the whole sole touch the floor when you stand or walk. This is a very common yet painless condition. The condition may develop in childhood and in other cases, an injury or due to the wear and tear of the feet.

Though it’s considered painless, it may lead to problems in the other parts of the body like the knees and ankles.

2Types of flatfoot

Short Achilles tendon – This type of flatfeet is caused by the size of the Achilles tendon. This tendon connects the heel bone to the leg’s calf muscle. If the tendon is too short, the person may have pain when running or walking. The condition also leads to the lifting of the arch permanently.

Flexible flat foot – This is considered the most common type of flatfoot. In this condition, the arch of the foot will only appear when you lift them off the floor or ground. The shape of the arch will return to normal when it’s touching the floor.

Posterior Tibial Tendon Dysfunction

Posterior tibial tendon dysfunction is a type of flatfoot that is acquired during adulthood. Usually, it connects the calf muscle. If the foot’s arch does not have the needed support, the pain will be felt in the foot and ankle.


Anatomy – Flatfeet may be due to how the feet have been made. It depends on the anatomy of the feet. It can also be inherited just as people inherit the physical traits of the parents and ancestors.

Young kids – Young children all have flat feet. They only develop the arch of the feet when they get older. In some cases, they never develop the arch.

Torn tendons – When the tibial tendon is torn or injured, it will lead to flat feet.

The gradual stretch of the posterior tibial tendon – When the tibial tendon is stretched, which is common in women who are 40 years old and above since they are wearing high-heels for long periods.

Medical conditions – Medical conditions that affect the nerves can lead to flat feet. These conditions include muscular dystrophy, Parkinson’s disease, and cerebral palsy.

Conditions of the joints – Some conditions affecting the joints and soft tissues may lead to flat feet. Arthritis, for one, is a common disease of the joints.

Damage to the bones of the foot or ankle – Bone damage as a result of the wear and tear or everyday use may also lead to flat feet.

Flatfeet are also more likely to occur in people with:

Hypertension – High blood pressure can affect the circulation of blood to the tendons of the lower extremities.

Obesity – Being obese may negatively impact the bones and muscles of the lower extremities. The excess weight placed on the tendons, which support the arch may collapse or become damaged.

Diabetes – Diabetes can affect not only the blood circulation to the feet but also, damage to the nerves in the area. The tendons may become weak, too.

Old age – People who are older are prone to having flat feet because when one grows old, the tendons and bones may experience the wear and tear. As a result, they may become weak and brittle.

Rheumatoid arthritis – Rheumatoid arthritis is the inflammation of the joints caused by autoimmunity. It can also weaken the tendons.

The long history of running and standing – Occupations that require long hours of standing and those who are marathon runners, they can develop flatfeet in the long run.


Most individuals have no signs or symptoms related to flat feet. However, others with the condition may experience foot pain at some point, especially the arch area of the feet. Activity may worsen the pain experienced and in some areas, there can be inflammation.

Here are the common signs and symptoms of flat feet:

  • Pain in the feet, particularly in the heel and arch of the feet
  • The feet will feel tired easily
  • Picking the nose
  • Swelling in the inside bottom of the feet
  • Back pain
  • Leg pain
  • Foot movement like standing on the toes is hard

When to seek medical attention:

See or consult your doctor if you have flat feet and you experience:

  • Your feet are painful even when you wear comfortable shoes or footwear
  • The shoes wear out or become overused quickly
  • The feet are weak, stiff and there is a tingling sensation
  • The feet’s arch becomes flatter
  • Foot movement like standing on the toes is hard

The doctor will examine your foot and determine what treatments may help. He can refer you to a specialist, an orthopedic surgeon or a podiatrist to discuss treatment options.

5Complications associated with flat feet:

Pain – In some patients, there is no pain but for others, pain is their ultimate nemesis.
The pain and swelling may take a toll on one’s daily activities.

Shin splint – Flatfeet can lead to the development of shin splints, a condition wherein the shinbone on the leg becomes inflamed due to overuse because of the improper foot shape and form.

The other complications are bunions, arthritis, hammertoe, tendinitis, and calluses.
These can all affect one’s comfort and mobility.

6Risk Factors

The factors that could contribute to the risk of having flat feet include:


Many tests can be done to diagnose flatfeet. First off, the doctor will conduct a complete medical history review and a thorough physical assessment. He may request the patient to do certain feet movements like standing on the toes and others. The doctor will then observe the feet from the back and the front.

Other tests include:

Imaging tests

X-ray – An X-ray would produce images of the bones and joints in the extremities, particularly in the feet. It can detect arthritis and the presence of other foot problems.

CT scan – The CT scan will show the soft tissues and the bones, which is more detailed than an X-ray. Also, the images are 3-dimensional.

MRI scan – The magnetic resonance imaging scan (MRI) uses radio waves and a potent magnet to produce 3D images of both the bones and the soft tissues.


If the flat foot is caused by an underlying medical condition, it may need treatment. Doctors would prefer recommending non-surgical methods first before surgery is needed.

Non-surgical methods – The doctor may recommend the patient to:

  • Wear supportive shoes that are not ill-fitting and constrictive or tight.
  • Wear orthotics or custom-made insoles to support the feet and the arch
  • Take pain relievers for pain and swelling.
  • Lose weight if you’re overweight or obese
  • Stretch the muscles and connective tissues to the lower extremities to help stop the foot from rolling over.
  • You need to cut down on activities that can bring you discomfort and pain. Avoid activities just like standing for long periods and walking frequently.
  • Lose weight if you’re overweight or obese
  • In some cases, you need to wear a cast to immobilize the foot.
  • Shoe modifications can help like choosing shoes that provide support to the arch.

These noninvasive treatments will not alter the shape of the feet but will aid in pain relief. If the measures do not work, the doctor can refer you to a specialist called an orthopedic surgeon.


Surgery is an option if the treatments stated were not effective and have not relieved the pain. If there is an underlying condition wherein undergoing an operation is needed. There are many types of surgeries, depending on the cause of the flat feet. For instance, an operation is recommended for deformed bones in the feet and other deformities.

The surgeon will talk to you about the surgery and what are the things to expect. In some patients whose pain is not really relieved by other treatments, surgery should be considered. It’s a very effective way to correct the situation and even the underlying cause. In choosing the procedure or operation needed, the doctor might note the severity of the condition based on the diagnostic findings. Also, he will consider factors like age and activity level.

Therapy – If the condition causes severe pain, therapies may be helpful.

Stretching exercises – These are exercises that can stretch the Achilles tendon if it’s short.

Arch support or orthotics – Orthotics are custom-made insoles that can provide support to the arch.

Supportive shoes – Some shoes are structured to support the arch and can provide pain relief.

Physical therapy – Another option is physical therapy. Flatfeet can contribute to overuse injuries in people who stand for long periods or marathon runners.

Lifestyle remedies

Arch supports – Just stated earlier, orthotics provide support to the arch that can provide pain relief and comfort.

Rest – Do not engage in activities that can aggravate or worsen the flat feet. Perform low-impact activities like biking, walking and swimming, and not engage in running and jumping because they put more pressure on the feet.

Weight loss – Losing weight can significantly reduce the stress on the feet. Also, maintain a healthy weight.

Medicines – Pain relievers and anti-inflammatory drugs may help provide relief for pain and swelling if there are.