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Flat Feet - Causes, Diagnosis, and Treatment

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When the inside arches of the feet are flattened, the patient has flatfeet, causing the soles to touch the floor when the patient stands up.

Medically reviewed by

Dr. Anuj Nigam

Published At December 1, 2022
Reviewed AtApril 13, 2024


If the inside of the foot’s arches are flattened, and the entire foot sole touches the floor when the patient stands up, the patient has flatfeet. A person with flat feet has no visible arch when standing. Each and every infant has flat feet. Arches form during early childhood. If arches fail to grow or collapse later in life, flat feet can cause pain and make walking challenging (fallen arches). Stretching and orthotic exercises are good. When the arches do not grow during childhood, resulting in flatfeet, a common and typically painless ailment. In other instances, flatfeet arise as a result of an accident or from age-related wear-and-tear stressors. Because the condition can change how the legs are aligned, flatfeet can occasionally create issues with the ankles and knees. Flatfeet typically do not require treatment if the patient is not in discomfort.

What Are the Types of Flat Feet?

Whether they emerge in maturity or continue to exist after childhood, flat feet can cause issues.

The various forms of flat feet include the following:

  • Flexible: The most typical flat feet are flexible. Even when the patient is not standing still, the patient can see the foot arches. When the patient puts weight on the feet, the arches vanish. Early childhood or adolescence is when flexible flatfoot first appears. Both feet are affected, and it steadily grows worse with age. The tendons and ligaments of the foot arches are prone to swelling, stretching, and tearing.

  • Rigid: Adult acquired flat foot (fallen arch): The arch of the foot abruptly descends or collapses in adults with acquired flat feet (fallen arch).

  • The foot turns outward due to the falling arch, which can be unpleasant.

  • One foot only could be impacted by the issue.

  • The most common cause is inflammation or a tear in the leg tendon (posterior tibial tendon) that supports the arch.

  • Vertical Talus: A birth condition (congenital handicap) known as vertical talus prevents arches from developing in some infants. The talus bone in the ankle is positioned incorrectly. The foot's bottom has a rocking chair-like appearance. The term rocker-bottom foot also applies to the vertical talus.

What Are the Causes Leading To Flat Feet?

  • Flat feet could run in the family.

  • A child's feet develop arches as they get older.

  • Some people's arches are high, while others are flat or almost so, resulting in flat feet. Some people get flat feet as they age. Sometimes, the illness runs in families. Additional issues that raise the chance of flat feet include:

  • Injury to the Achilles tendon (the tendon connecting calf muscles to the heel).

  • Fractured bones.

  • Brain damage.

  • Diabetes.

  • Down syndrome.

  • Elevated blood pressure

  • Obesity.

  • Pregnancy.

  • Arthritis rheumatica.

Because the foot's arch has not yet formed, newborns and toddlers typically have flat feet. Most individuals' arches form throughout childhood, but some people never do. People with flat feet may or may not experience problems because of a typical difference in the foot type. When a patient is sitting or standing on tiptoes, the arch of their flexible flatfoot may be seen, but when they stand, the arch vanishes. The majority of kids grow out of flexible flatfoot without any issues. Over time, arches may potentially collapse. Wear and tear over time may cause the tendon that supports the arch and runs along the inside of the ankle to weaken.

What Are the Symptoms Experienced by Patients with Flat Feet?

Many individuals with flat feet do not have any discomfort or other issues. However, some flatfoot variations can cause discomfort. Some signs could be

  • Leg pains.

  • Leg or foot muscle pain (aching or tiredness).

  • Pain in the outside of the foot, the heel, the ankle, or the arch.

  • Alterations in the gait or discomfort (how the patient walks).

  • Toe splay (front part of the foot and toes point outward).

Most persons with flatfeet do not exhibit any symptoms or warning signals. However, some flat-foot individuals have foot pain, especially in the heel or arch region. Activity may make the pain worse. There may also be swelling on the inside of the ankle.

What Are the Risk Factors Behind Flat Feet?

The risk of developing a flatfeet increases due to several factors, including:

How Are Flat Feet Diagnosed?

Doctors can usually diagnose flat feet by asking questions and doing an exam. The following imaging studies may be useful in determining the source of foot pain:

  • Radiography: A basic X-ray creates images of the foot's bones and joints with little radiation. It is very helpful for assessing alignment and identifying arthritis.

  • CT scan: Compared to a typical X-ray, this examination delivers far more detail by taking X-rays of the feet from several angles.

  • Ultrasound: In cases where a tendon injury is suspected, ultrasound may be employed. Sound waves are used in ultrasound technology to create finely detailed images of the body's soft tissues.

  • MRI: MRIs offer exceptional detail of soft tissues and bone because they use radio waves and a powerful magnet.

How Are Flat Feet Managed and Treated?

Many persons with flat feet do not require medical attention or have serious issues. If an individual has problems such as stiffness, discomfort, or other problems in the feet, the doctor might suggest nonsurgical therapy. Surgery is rarely required to treat problems with bones, tendons, or stiff, flat feet.

Among the treatments are:

  • Use cold packs, rest, and nonsteroidal anti-inflammatory medicines (NSAIDs) to reduce pain and inflammation.

  • Physical therapy can increase flexibility and mobility by strengthening and stretching tense muscles and tendons.

  • Supportive equipment includes bespoke shoes, foot orthotics, and leg or foot braces.

What Exercises Can Cure Flat Feet?

  1. Towel Scrunch:

This easy exercise helps strengthen the body's arches. It calls for an individual to use just one towel and to stay seated. The steps are as follows:

  • Start by placing a towel flat at the feet while seated in a chair.

  • Until the person cannot drag the towel beneath their foot any farther, grasp at the towel with just their toe muscles.

Repeat it a few times.

2. Step-By-Step Instruction for Stair Heel Raises:

  • Simply placing the toes and the heel of the feet on a step allows a person to stand partially on it.

  • Press in gradually and lift the foot's heel into the air.

  • After a short while of holding, release the tension and lower the feet again. One must fight the impulse to drop the heel below the staircase line to get the most out of this exercise.

3. Toe Extensions:

This gentle stretch targets the muscles on the top of the feet that assist in controlling toe movement. It is a variation of a toe extensor stretch.

  • Apply light pressure to the toe fingers till the knuckles are visible, then hold the position for 20 seconds.

  • To increase strength and flexibility, perform the stretch three to four times during a session.

4. Stretch With the Help of a Towel:

This technique is useful for relieving the Achilles tendon's stiffness or inflammation.

  • Start by wrapping a towel around the soles of the feet while seated on the floor.

  • Pull the towel inward towards oneself while maintaining a straight torso and knees until it feels the Achilles tendon stretching.

  • Release after thirty seconds of holding, then repeat.

5. The Stork Stretch:

It involves placing one of the feet on the floor and raising the other foot gradually to put more pressure on the foot on the floor.

  • Greater heel stress should be applied as if someone were lifting their foot off the arch. (One can stand next to the wall or some furniture for assistance).

  • Stretch the muscles by holding the position for ten seconds. Then, release oneself and repeat with the other foot.

6. Foot Roller:

  • Stay seated and position a frozen drink can or a foot roller face in front of them.

  • With the heel of the foot, apply moderate pressure and press down on the can; then, roll the roller back towards the heel.

7. Heel Raise:

Maintain a standing position with both feet flat on the ground. If necessary, one can grab onto something for support.

  • Lift the heels off the ground and use only the soles of the feet to push themselves up.

  • After a few seconds of holding this position, progressively lower oneself back down.

8. Stretching for Plantar Fasciitis:

  • It involves placing the feet against a wall and keeping the heels and arches as level as possible to allow the toes to spread. One can also position a foam roller or tennis ball in front for added comfort and support.

  • For ten seconds, hold the stretch.

9. Toe Crawl:

  • Assume a straight chair position and place both feet flat on the ground.

  • The feet should be scrunched up as though one is attempting to grasp the ground.

  • Now, move the entire foot forward as if it were crawling by using the toes.

10. Walk Barefoot:

Going barefoot for a short period each day might help strengthen the feet in addition to the stretches and workouts mentioned above. According to research, going barefoot for extended periods helps improve the feet's tendons, ligaments, muscles, and bones. People can exercise their feet by walking barefoot in parks and along the beach or using a foot massage mat.


Flatfoot is a biomechanical disorder frequently seen in clinical practice. The tissues and bones in the lower legs and feet are linked to flat feet. Since it requires time for the tendons to tighten and form an arch, the situation is normal in babies and toddlers. Most of the time, doctors can identify flat feet by questioning and physical examination. They can request imaging tests like X-rays if necessary. When the arches do not grow during childhood, flatfeet can happen (a common and typically painless ailment). The most standard treatment is for the patient to wear corrective footwear with complete arch support. Individuals can choose and purchase insole arch supports for effective treatment of flat feet.

Frequently Asked Questions


Can Flat Feet Be Cured?

Flat feet can be treated with various modalities. The treatment options include:
- Arch support to improve foot alignment.
- Physical therapy to improve gait and strengthen the foot muscles.
- Certain footwear modifications include avoiding high heels and shoes with good arch support.
- Medications like non-steroidal anti-inflammatory drugs may relieve inflammation and pain. 
- surgery.


Is a Flat Foot Considered a Disability?

Flat feet are not considered a disability. The main limitation is mobility, which can be managed with conservative treatment. In some situations, it can be considered a disability, such as being unable to stand or walk. It is considered a disability depending on the severity of the condition and its impact on the person's work performance. 


What Workout Helps Flat Feet?

Flat feet can be due to weakness and tightness in the foot muscles and lower legs. Exercise can improve foot posture. 
Some exercises are as follows:
- Toe Curls: A person has to sit on a chair with feet on the floor. Place a towel under the feet and use the toes to scrunch the towel.
- Heel Raises: A person has to stand with their hips wide apart and rise on their toes. Hold for a few seconds and place down the feet on the floor.
- Arch Lifts: A person has to sit with feet on the floor and toes pointing forward. Lift the arch of the feet, keeping the heels and toes in contact with the ground. 
- Ankle Rotations: A person has to sit with legs extended and rotate the ankles in a circular motion, clockwise and anti-clockwise.
- Calf Stretches: A person must stand toward the wall and place their hands on it for support. Place one foot back and press the heel into the ground. 


What Are the Benefits of Flat Feet?

The advantages of flat feet are as follows:
- It can provide better shock absorption.
- It can provide balance and stability while standing and walking.
- It increases flexibility in the feet and ankles.
- It is linked to the dexterity of the toes.


Is Flat Foot Hereditary?

Flat feet are genetic, meaning that they pass from parent to child. But, only some of the cases are genetic. The condition can be due to other factors, including obesity, injury, and medical conditions. 


Who Is More Prone to Flat Feet?

Flat feet can affect all ages and sexes. Certain factors may increase the condition, including obesity, injury, age, pregnancy, and medical conditions like diabetes, arthritis, or cerebral palsy. 


What Footwear Are Best for Flat Feet?

The footwear is as follows:
- Motion control shoes provide support and stability. 
- Stability shoes provide balance and support.
- Arch-support shoes can help with the support of feet.
- Custom orthotics provide support. 


What Are the Drawbacks of Flat Feet?

The drawbacks of flat feet are as follows:
- Foot pain.
- Ankle pain.
- Knee pain.
- Hip pain.
- Lower back pain.
- Difficulty with balance.
- Increased risk of injury.


Do Flat Feet Affect Legs?

Flat feet can affect the legs. Some ways that the condition affects the legs are as follows:
- Overpronation means the foot rolls inward too much while running and walking. 
- Alignment issues result in pain, instability, and discomfort.
- Muscle imbalances in the legs.
- Increased risk of injury.


How to Get Rid of Flat Feet?

- Some things can get rid of flat feet.
- Wear supportive shoes.
- Use orthotics.
- Maintain a healthy weight.
- Stay active.
- Avoid activities that put a strain on the feet.
- Stretch and strengthen the feet.
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Dr. Anuj Nigam
Dr. Anuj Nigam

Orthopedician and Traumatology


flat feet
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