Condition, Flat Feet

What are Flat Feet? Diagnosis, Pain Treatment, and Symptoms


The middle of an adult foot has an upward curve. This curve is known as the arch. When the arch is absent in one foot or both, the condition is known as flat feet. The bottom of the affected foot will always touch the ground flat when in a standing position because the curve is not there. To understand the condition even better, look at the feet of babies. All babies’ feet are flat from birth until about age 6 when the arches start to form. 

As the child grows, the arch should form fully such that it is visible and properly functional. When the arch fails to form properly then the result is flat feet. About 20-30 percent of the general population have this condition either on both feet (bilaterally) or on one of their feet only (unilaterally).

What Are The Symptoms of Flat Feet?

Depending on the severity, some of the affected people might experience common signs and symptoms which include: 

  • Pain around the feet 
  • Cramps around the leg
  • Pain and swelling around the inner ankle
  • The front part of the toe may point outwards 
  • Lower back pain
  • Discomfort in the foot such as pain after standing, running, or even after a simple walk
  • The feet tend to tire fast as more energy is used when walking or standing.

It is important to note that besides the most significant sign of flat feet which is the absence of the arch, there are no symptoms of concern exhibited by most of those who have the flat feet condition. A sizable number of people live with this condition with no pain.

What Are The Common Causes of Flat Feet

Flat feet is caused by the failure of tendons to tighten properly in order to form the arch. The tightening of tendons is an important natural process that occurs early on in life from the time one is a toddler. By the time one grows into an adult, the tendons should have tightened enough by this stage and the arches should be well-formed. If this process is not accomplished, then it results in flat feet condition. 

Common causes include:

  • Torn or stretched tendons
  • Damage to the PTT (posterior tibial tendon), which creates the connection between the lower leg to the arch through the ankle. When this tendon is damaged, it becomes dysfunctional and fails to support the arch. 
  • Bones that are damaged as a result of breaking or dislocation
  • Health conditions like cerebral palsy or  rheumatoid arthritis
  • Problems to do with the nerve system
  • Other factors such as diabetes, aging, obesity

How Do You Diagnose Flat Feet?

Diagnosis of complications associated with the feet can prove difficult given that the size of a foot is small and there is the likelihood that other illnesses could be easily mistaken for flatfeet. This is why a podiatric specialist with deep knowledge of foot complications is the right person to perform a diagnosis, especially where the pain is involved. 

A diagnosis of flat feet is normally conducted with the aim of determining two important items. First is to establish whether the flatfeet condition exists in the feet of the person being examined. Second is to determine the underlying causes.

During diagnosis, your specialist can do the following 

  • Check the history of your health including any cases of injuries or diseases like cancer that may be linked to flatfeet
  • Examine the soles of your shoes for signs of wear indicators that are associated with flat feet. 
  • Observe the movement of the legs and the feet when the toes are raised. 
  • Check the strength of tendons including the Achilles tendon or the PTT (posterior tibial tendon). 
  • Check the strength of muscles
  • Perform imaging tests such as X-rays of your feet to check for any damages to joints and bones. Ultrasound can also be used if the specialist feels that a tendon may be damaged. 

Can You Self-Diagnosis of Flat Feet?

While a proper and professional diagnosis can only be done by a podiatrist, it is still possible to do self-diagnosis by yourself using the following tests. 

    1. The wet test

When it comes to self-diagnosis of flat feet at home, a simple test known as the wet test is the easiest and most popular. Simply wet your feet ‘ bottoms using clean water, then stand in a normal position while stepping on a flat piece of paper that is long and wide enough to accommodate your entire feet. The piece of paper you step on should also be clear enough to show the clear imprints of your footprints once you step off. Once your feet are wet, step on the paper for a few seconds then step off. Take a look at the footprints’ imprints on the paper. If the imprint left on the paper is curved on the inner sides of your feet, then you do not have flat feet. But if the imprint on the paper shows the entire foot’s bottom, then you have flatfeet. 

    2. Shoe inspection

Another easy flatfeet diagnosis you can conduct by yourself is the shoe inspection which, just as the phrase implies, involves inspecting your shoes. Take a keen look at the sole of your shoes. If you notice that there is a lot of wear inside the sole and especially the area around the heel, then that is a sign of flat feet. The upper part of the shoe will also be leaning over the sole, inwards. 

What Are The Treatments For Flat Feet?

Treatment may not be necessary if your flat feet are not painful. However, some flat feet conditions can be painful and if that is the case then your specialist may recommend the following remedies to help  ease those foot pain:

  1. Arch supports

Also known as orthotic devices, these are over-the-counter supports that help to ease the pain and stress on the feet. They help to align the feet as well as improve their functions. If the over-the-counter supports are not suitable for your feet, then the doctor can suggest custom-made supports that will be modeled to suit your feet. 

  1. Supportive shoes

Certain shoes are made to be supportive for people with flat feet. The shoes are made in a way that is structurally possible to offer support, especially when walking or standing. They are super good at offering the much-needed cushioning and vital support to the arches. 

  1. Stretching exercises

Certain exercises help to stretch the feet especially in cases where the Achilles tendons are shortened.  Some of the exercises you can perform include heel stretches, tennis ball rolls, stair arch raises, calf raises, toe raises, and towel curls. Consult a physical therapist for advice on specific exercises that are most suitable for your body.

  1. Corrective surgery

The main purpose of surgery is to try and correct any underlying problems such as a deformity in the bones, rupture, or tear in tendons.  Chronic pain conditions as a result of flatfeet may also necessitate surgery, specifically if the pain fails to go away after exhausting other treatments. 

Surgery may not necessarily correct a flat feet condition but will help solve the underlying condition with the benefit of preventing further complications. 

Good examples where surgery might be necessary is where certain bones fail to form properly at a young age, resulting in flat feet. 

Common flat feet surgery procedures

Some of the common surgical procedures in the treatment of flat feet include:

  • Excision: The removal of extra bone growth 
  • Arthrodesis: the fusing together of bones 
  • Synovectomy: The cleaning up of the coverings that protect the tendons 
  • Lateral lengthening of the column: Grafting a bone to the feet to help the arch rise
  • Tenon addition:  The transfer of a tendon from another part of your body and adding it to your feet tendons to help in the tightening and firming of the arch
  • Osteotomy: Adjusting the shape of the bone or cutting the bone altogether. 

Keep off activities that initiate or worsen the pain. Some of the common activities to avoid include running, jumping, or playing sports that involve lots of vigorous movements such as football. Engage in activities that don’t put a lot of impact on the feet such as swimming or biking.

Make necessary adjustments however small they might be, to ensure you are always operating within the most comfortable positions. This will reduce incidences of pain and ensure you live a comfortable life without ever having to worry about the condition. 

Who Is at High Risk of Developing Flat Feet

The flat feet condition is more likely to affect the following categories of people:

  • Those from families with a history of flat feet problems
  • Highly athletic persons
  • Physically active individuals
  • Older people are more prone to physical injuries that can lead to flat feet
  • People already affected with muscle-related diseases like cerebral palsy
  • Obesity, which stresses the feet structure during development thus leading to deformity
  •  Diabetes and hypertension are also considered high-risk factors


If you are living with flat feet, it helps to understand the condition thoroughly so that you are better prepared to deal with any changes that need attention. Make an effort to understand your body by taking a keen interest in how you move, how you stand, and generally the positions your body takes when performing routine activities. 

Photo by Brina Blum on Unsplash