Introduction
Flatfoot, also known as fallen arches, is one of the most common conditions seen in podiatry clinics. For some, it causes no symptoms at all; for others, it leads to pain, fatigue, difficulty walking, and even knee, hip, or back problems. Children are often brought in by concerned parents when their arches don’t appear to “form,” while adults may notice progressive arch collapse later in life. The key is understanding when flat feet are harmless — and when they signal something more serious.
What Is Flatfoot?
A healthy foot has an arch that supports body weight and helps absorb shock. In flatfoot, the arch is absent or collapses when standing. Flatfoot comes in two main forms:
● Flexible flatfoot: The arch is visible when not weight-bearing but disappears when standing. Common in children and usually painless.
● Rigid flatfoot: The arch is absent even when sitting. This type is more concerning and often painful.
In adults, progressive flatfoot is often linked to dysfunction of the posterior tibial tendon — the structure that supports the arch.
Causes in Children
● Normal developmental flatfoot (most kids outgrow it by age 6–8).
● Neurological or muscular conditions (rare).
● Genetic predisposition.
Causes in Adults
● Posterior tibial tendon dysfunction (PTTD) from overuse or injury.
● Arthritis of the foot or ankle.
● Trauma or fractures.
● Obesity, diabetes, or aging-related ligament changes.
Symptoms
Not all flat feet are painful, but when they are, common complaints include:
● Arch or heel pain.
● Swelling along the inside of the ankle.
● Difficulty standing on tiptoe.
● Fatigue or aching in the legs after activity.
● Outward tilting of the heel.
Impact on Daily Life
Flatfoot can make standing for long hours exhausting. Athletes may notice decreased performance, while workers in active jobs often complain of leg and back pain. In children, parents may notice clumsiness, reluctance to participate in sports, or uneven shoe wear.
When to See a Specialist
You should seek care if:
● Your child’s flatfoot is painful or rigid.
● You’re an adult with worsening arch collapse.
● Pain interferes with daily activities.
● The deformity is progressing.
Treatment Options
Non-Surgical
● Supportive footwear with firm arch support.
● Orthotics (custom or prefabricated) to realign the foot.
● Physical therapy to strengthen foot and ankle muscles.
● Bracing for significant tendon weakness.
● Anti-inflammatory medication for pain relief.
Surgical
Surgery is considered for severe or progressive cases. Options may include tendon repair, osteotomies (bone cuts and repositioning), or fusion procedures. Recovery depends on the surgery but often restores function and reduces pain long-term.
Prevention and Lifestyle Tips
● Maintain a healthy weight to reduce stress on arches.
● Wear supportive shoes daily — avoid flimsy sandals or flat flip-flops for prolonged use.
● Stretch the Achilles tendon and calves to improve flexibility.
● Don’t ignore foot or ankle pain — early treatment is easier and more effective.
Myths About Flatfoot
● “All flat feet need surgery.” Not true — most cases are managed conservatively.
● “Flatfoot always causes pain.” Many people with flat feet live without symptoms.
● “Kids will always outgrow flat feet.” Many do, but painful or rigid flatfoot in children requires evaluation.
Conclusion
Flatfoot is common and often harmless, but it can also be a warning sign of tendon problems or arthritis. The key is knowing when to watch and when to act. With modern orthotics, physical therapy, and surgical options, patients can stay active and pain-free. If flat feet are causing discomfort for you or your child, don’t wait — Dr. Kamel can provide solutions that keep you moving with confidence.