What are Flat Feet

Flat feet is a common term used to describe feet that pronate or roll-in too much at the ankle joint and midfoot. The arch height in these feet are much lower and there is a noticeable bulging present at the inside of the ankle joint.

During the gait cycle, all feet pronate or roll in; it is how the body naturally absorbs shocks/pressures from the ground as you walk. However, if the foot pronates too much or at the wrong time during the gait cycle, this can lead to muscle fatigue, cramping, pain, and injuries. It is also important to remember a foot can appear to have a normal arch height when standing, but then flatten or roll-in excessively during the gait cycle once forces are applied to the legs and feet.

Causes of Flat Feet  

  • Hypermobility (loose ligaments) – Ligaments provide support to joints. If ligaments are highly flexible, joints in the foot may become malaligned causing the arches to sag and the ankles appear to roll-in. Hyper-mobility is present in approximately 10% of the population.
  • Hereditary bony or soft tissue conditions –  Can cause abnormalities within the foot that disrupt normal walking patterns. This causes the foot to “unlock” allowing the arch to fall closer to the ground.
  • Obesity – Obesity can place extra stress on foot structures, resulting in collapse of the arch or rolling-in.
  • Pregnancy – Flat feet can occur during pregnancy due to weight gain and the increase in ligament flexibility.
  • Tarsal Coalitions –  An abnormal connection of two or more bones in the foot that causes restriction in joint mobility and compensatory dysfunction and pain.
  • Leg length difference
  • Mechanical dysfunction

Associated Problems of Flat Feet

Flat feet are associated with a number of lower limb injuries including heel pain, ankle pain, shin pain and knee pain. These could be exacerbated depending on the type and level of activity you perform. Activities such as running can place up to 3-4 times your body-weight of force on your feet.

Flat feet are relatively normal in infants, partially due to an increase in fat in this area, and also due to the arch not yet being fully developed. As the child ages, the arches of the foot should increasingly become visible and the amount of rolling-in should reduce. Flat-feet and excessive rolling-in in the teenage years and adulthood, however, is less common and can cause problems.

Treatment for Flat Feet 

Appropriate footwear and orthotics are vital to help re-align the lower-limb and remove the excess pronation and internal/external forces that could cause foot and ankle injury and pain. Our podiatrists at OnePointHealth can help by prescribing and recommending:

  • Adequate footwear: Suitable footwear plays a major role in supporting the foot, and decreasing the risk of pain and injury. There are thousands of shoes on the market and choosing the right one with adequate support can be overwhelming. We can recommend specific shoes that are supportive for your feet, regardless of age, gender and activity.
  • Orthotic therapy: Is often highly beneficial for people who suffer pain and injury associated with their flat feet. Orthotics can achieve this by restoring ideal foot function and posture, thus decreasing the stresses placed on the surrounding muscles and joints.
  • Exercise program: Can help address muscle imbalances or restrictions to help improve stability of your feet.
  • Soft tissue therapies: Such as deep tissue massage and joint mobilisations can help reduce compensation through joints associated with tight and weak muscles.

Surgery for Flat Feet 

In cases that are non-responsive to conservative treatment, surgical intervention may be required.