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Flat Foot

(Pes Planus; Pes Planovalgus; Fallen Arches)

by Ricker Polsdorfer, MD

En Español (Spanish Version)

Definition

Feet usually have an arch on the inside portion of the foot. A flat foot is a foot that has lost or never developed this arch.

Most flat feet are flexible. This type causes no problems, and do not require treatment. Rigid flat feet can cause problems and are best treated.

Normal Foot Arch

Causes

Infants and young children naturally have flat feet. The arch should develop over time. Sometimes the arch does not develop. It is not always clear why this happens. It may be associated with

Congenital problem—condition present at birth
Family history—conditions that cause flat feet (loose joints) may run in families

Flat feet may develop because of:

Ruptured or damaged ankle tendon that supports the arch
Foot injury
Medical conditions that affect muscle balance

Risk Factors

Factors that increase your chance of flat feet include:

Familial tendency
Foot injuries
Conditions of the feet that can injure foot tissue such as osteoarthritis
Diseases that cause muscle or nerve damage, such as diabetes, cerebral palsy, spina bifida, or muscular dystrophy

Symptoms

Flat feet may not cause any symptoms at all. Rigid flat feet may cause:

Pain
Calluses, blisters, or skin redness on the innerside of the foot
A stiff foot
Weakness or numbness of the foot
Rapid wearing out of shoes—worn shoes lean in toward each other
Difficulty with activities like running—may indicate that the foot is having trouble doing its job

Diagnosis

Your doctor will ask about your symptoms and medical history. A physical and foot exam will be done. Flat feet can be diagnosed by appearance. To determine if the foot is rigid, you may be asked to do some simple tasks.

Treatment

If the flat foot is rigid and causing problems, you will be referred to a foot specialist. Talk with your doctor about the best treatment plan for you. Options include the following:

Physical therapy may relieve discomfort. They may help you with a specific stretching and strength program. They may also apply treatment to help manage the discomfort.

Exercises can help with the strength of the surrounding muscles. It may relieve some of the pressure in the foot.

Orthotics are shoe inserts that support the foot. These inserts may help to reduce pain and disability. In mild cases, a well-fitting pair of shoes with arch support may be all that is needed.

Flat feet caused by nerve or muscle disease may need special braces.

Feet that do not respond to the treatments above may need surgery. The surgery will help to create a supportive arch.

Prevention

Well-fitted shoes with good arch support may help prevent flat feet. Maintaining a healthy weight may also lower wear and tear on the arches.

American Academy of Orthopaedic Surgeons

http://www.aaos.org/

American College of Foot and Ankle Surgeons

http://www.footphysicians.com/

Canadian Podiatric Medical Association

http://www.podiatrycanada.org/

Nurses Entrepreneurial Foot Care Association of Canada

http://www.nefca.ca/news.php/

Flat feet. American Academy of Orthopedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00173. Accessed December 28, 2012.

Flat foot. UCSF Children’s Hospital website. Available at: http://www.ucsfhealth.org/childrens/medical_services/ortho/foot/conditions/flatfoot/signs.html Accessed December 28, 2012.

Pes planus. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated November 12, 2010. Accessed December 28, 2012.

11/19/2010 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php: Rome K, Ashford R, Evans A. Non-surgical interventions for paediatric pes planus. Cochrane Database Syst Rev. 2010;(7):CD006311.

Last reviewed November 2012 by Michael Woods, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.