Flat Feet

Flat feet describe a low or flattened arch, and they may be painless or contribute to foot, ankle or leg discomfort. Flat feet, also called pes planus or fallen arches, occur when the inside arch of the foot is low or becomes flatter while standing. Some people have flexible arches that appear when the foot is lifted; others have a more rigid shape. Flat feet are not automatically a problem, but symptoms can develop when the foot and ankle are under repeated strain.

Flat feet may cause arch pain, foot pain, ankle aching or tired legs after walking and standing. Shoes may wear unevenly, and the ankles may roll inward as weight is placed through the foot. Pain can extend toward the heel, shin, knee or hip when the altered foot position changes how the leg moves.

Some arches are naturally low from childhood. In adults, the arch may flatten because of tendon or ligament weakness, injury, arthritis, increased load or changes in foot mechanics. One foot changing more than the other, especially with pain, can point to a condition that needs assessment.

Flexible flat feet may remain stable for years. Symptoms can appear when activity, body load or footwear changes. A progressively flattening adult foot may become more painful and less flexible, particularly if the tendon supporting the arch is not working well. Early assessment can clarify whether the shape is flexible or rigid.

Factors linked with symptoms include family foot shape, previous ankle or foot injury, unsupportive footwear, prolonged standing, higher training loads and conditions that affect joints or connective tissue. These factors can increase strain but do not mean pain will develop.

A clinician assesses the arch while sitting and standing, observes walking, checks ankle movement and tests strength in the foot and calf. Imaging may be used when injury, arthritis or a rigid deformity is suspected. Mention where pain occurs, which shoes worsen it and whether one foot is changing.

Painless flat feet often need no treatment. When symptoms are present, care may include footwear changes, activity adjustment, custom orthotics and physiotherapy. Exercise therapy can strengthen the calf, foot and hip muscles and improve control. Custom orthotics may redistribute pressure, but they should complement a broader plan rather than replace assessment.

Choose shoes with a stable sole and enough room for the toes. Increase walking or running gradually, and use low-impact activity during a painful period. Track whether discomfort follows a particular surface, shoe or training change so your clinician can adapt the plan.

Persistent altered loading may irritate the plantar fascia, shin tissues or kneecap area. Foot pain can also reduce activity and weaken supporting muscles. Sudden swelling, marked weakness, inability to bear weight or a rapidly changing arch should be assessed promptly.

Not every low arch can be prevented. Well-fitting footwear, gradual training changes, calf and foot strength and early attention to recurring pain can reduce avoidable overload. Children with no pain or functional difficulty may simply need observation.

A physiotherapist, podiatrist or orthopaedic clinician can assess alignment and guide treatment. Seek a clinician who examines both feet, watches you walk and explains why a support, exercise or imaging test is being recommended.