What Are Flat Feet

In a person with fallen arches, one or both feet may be flat on the ground, and shoes may wear unevenly, especially on one side, or they may wear out more quickly than usual.

Many people with fallen arches have no symptoms, but some may experience pain in their feet and even their back, depending on the cause.

Symptoms can vary and generally depend on the severity of the condition.

Some people have an uneven distribution of bodyweight and find that the heel of their shoes wears out more rapidly and more on one side than the other.

The most common symptom of flat feet is pain. Pain may occur in the feet, if the connecting ligaments and muscles are strained.

There may also be stiffness in one or both feet  and it may also present in the:

• Inner side of the ankle, and possibly swelling
• Arch of the foot
• Calf
• Knee
• Hip
• Back
• Lower leg area

The abnormal stresses on the knee and hip may result in pain. This is likely if the ankles turn inwards. Flat feet can also lead to pain in the low back.

Who gets flat feet?

In a human foot, there are 26 different bones, held together by 33 joints and over 100 muscles, tendons and ligaments.

The arches give spring to the step and distribute body weight across the feet and legs. The structures of the arches determine how a person walks. They need to be both sturdy and flexible to adapt to various surfaces and stress.

Causes of flat feet include:

• Genetic factors, as flat feet can run in families
• Weak arches, where the foot is visible for example, when sitting, but the foot flattens onto the ground when standing
• Foot or ankle injury
• Arthritisor rheumatoid arthritis
• Damage, dysfunction, or rupture of the posterior tibial tendon
• Nervous system or muscle diseases, such as cerebral palsy, muscular dystrophy, or spina bifida
• Tarsal coalition, where the bones of the foot fuse together in an unusual way, resulting in stiff and flat feet. This is most commonly diagnosed during childhood

People are more likely to develop flat feet if they have obesity or diabetes, or during pregnancy.

Flat feet can develop as people age. Daily use can cause the posterior tibial tendon to weaken. This tendon is the main support structure of the arch of the feet.

The tendon can become inflamed after overuse, known as tendinitis, or be torn. Damage to the tendon may cause the arch shape of the foot to flatten.

Flat feet can happen because of a developmental fault that occurs during childhood, or that develops with age, or after pregnancy.

Some people appear to have a very low arch or no arch without ever experiencing problems. Fallen arches or flat feet only need attention if they lead to discomfort, if they indicate another underlying disorder, or if they can lead to future pain elsewhere in the body.

Flat feet in children

Children and infants often look as if they have flat feet. The arch is usually there, but the feet are still forming. In time, the arch will appear as normal. The extra fat on an infant’s foot may also be hiding the arch.

Having apparently flat feet during early childhood does not mean that the person will always have flat feet.

However, if a child has flat feet because of incorrect bone development or another disease such as spina bifida, the underlying cause will need to be addressed.