Foot Pain

Flat foot

What is flat foot or 'pes planus'?

  • A flat foot is a deformity where the arch on the instep of your foot is low or collapsed, leaving minimal or no gap between the instep area of the foot and the ground.
  • The main job of the arch of the foot is to act as a shock absorber and reduce the force that goes through the leg.

What are the causes for flat foot?

  • Genetics: Having low or no arches is normal for some people. This is usually inherited and the feet are fairly flexible.
  • Tarsal coalition: sometimes, flat feet can be caused by an abnormality that develops in the womb, such as where two or more bones are fused together. This is known as tarsal coalition and results in the feet being flat and stiff.
  • Trauma: Flat feet that develop in later life can be caused by arthritis, or an injury to a muscle, tendon or joint in the foot.
  • Neurological conditions: Conditions that affect your brain and spinal cord can also cause the arches to fall for example cerebral palsy, spina bifida and muscular dystrophy.
  • Adult-acquired flat feet: often affects women over 40 years of age. This is considered to be associated with stretching of the tendons due to wearing high heels and standing or walking for long periods. Obesity, high blood pressure (hypertension) and diabetes are considered as risk factors.
  • Tendon degeneration: Recent research has identified some link with changes to the tendon in the foot and an increase in a type of protein called proteolytic enzyme. These enzymes can break down some areas of the tendon, weakening it and causing the foot arch to fall. These types of changes are also seen in other conditions, such as Achilles tendonitis.

What are the signs and symptoms?

  • Pain in the instep region with walking
  • Difficulty in standing for long periods of time.

How do I manage this problem?

  • Wear shoes that are supportive
  • Over the counter arch supports from the chemist may be helpful
  • Exercises to strengthen the small muscles of the foot and ankle may also help

What other treatments are available?

  • Your Podiatrist may be able to offer custom made orthotics for arch support.
  • In rare cases where the deformity is progressive and associated with weakness, specialist input may be suggested.