Flat Feet

What Are Flat Feet?

Flat feet (also known as fallen arch, flatfoot or pes planus) is a condition in which the feet have very low or non-existent arches. This causes the bottom of the entire foot to contact the ground.  Up to 30% of the population has flat feet.

There are two main types of flatfoot:

1. Flexible Flatfoot (flexible pes planus): The foot is only flat when bearing weight; otherwise the arch returns to normal.  This is common in young children and often goes away when the arch is fully formed between the ages of 7 and 10. About 10 to 25% of adults have flexible flat feet – most of them never develop any symptoms.  
2. Rigid Flatfoot (rigid pes planus):  The arch is flat regardless of the foot’s position. This type of flatfoot is more problematic.

Flatfoot disrupts the foot’s biomechanics by impeding the arch’s ability to properly support our body weight and absorb the force of our movement.  The load is then displaced onto the toes, ankles, knees, hips and lower back. As a result, pain can develop in these areas, as well as the feet.

In addition to causing pain and discomfort, flat feet can make you more susceptible to certain foot conditions, such as:

• Plantar fasciitis
• Achilles tendonitis
• Shin splints
• Posterior tibial tendon dysfunction
• Bunions
• Hammertoes
• Calluses

What Are The Symptoms Of Flat Feet?

What Can Cause Flat Feet?

Flat feet are very common in children. This usually goes away on its own as part of the natural growth process. Typically, the arches of the feet develop throughout childhood after the age of three. 

In adults, the foot may start out with a normal arch, but then collapses or falls due to various factors.  

Flexible flatfoot in adults is hereditary and associated with hyperflexible joints and ligaments throughout the body – not just the feet.  

Rigid flatfoot in adults can be either congenital (something hereditary that you’re born with) or acquired (Acquired Adult Flatfoot).  It is caused by major structural abnormalities in the bones and ligaments of the foot’s arch. 

The following can cause or contribute to the development of flatfoot in adults:

• Posterior Tibial Tendon Dysfunction (PTTD): The posterior tibial tendon supports the arch of the foot when we walk. When it is damaged, the arch collapses.  This is a common cause of acquired adult flatfoot.  Various factors can lead to PTTD (see below).
• High-impact injury or trauma that dislocates the talus bone (the bone located within the foot’s arch) or tears the posterior tibial tendon (the tendon that supports the arch).
• Unusual or prolonged stress to the foot: This damages the ligaments and bones holding up the arch. The stress may be due to underlying conditions (such as arthritis) or the residual effects of injury.
• Faulty biomechanics affecting the foot and the body’s overall movement:  Faulty biomechanics place excessive strain and pressure on the joints and muscles in our body.  This ultimately damages the muscles, ligaments and bones in the foot, which can lead to flatfoot.
• Aging:  The effects of wear-and-tear as we age can ultimately strain and damage the posterior tibial tendon.
• Pregnancy and Obesity:  The increased weight load on the joints can damage the structure of our foot’s bones, muscles and ligaments.  This can cause the arch to collapse.  
• Diabetic Collapse (Charcot Foot):  Charcot foot occurs in people with peripheral neuropathy, often associated with diabetes. Mechanical stress can cause fractures in the foot that go unnoticed and eventually deform the foot permanently. A common presentation is midfoot collapse and a foot with a rocker bottom deformity.

How Can I Treat Flat Feet?

Treatment for pain and complications resulting from flat feet may include:

• Footwear with interior arch support
• Motion control and stability shoes that help correct overpronation.  Our curated selection of specialty footwear provides many options.  
• Properly fitted custom orthotics or orthopedic shoes:  These will support your bodyweight, encourage healthy biomechanical movement, redistribute pressure evenly along the bottom of the foot and alleviate any excess strain the condition may have on your muscles and joints:  A chiropodist (foot specialist) can assess you for a custom orthotic for the unique needs of your feet.
• Modified insoles:  The knowledgeable staff at our foot clinic can help you find insoles specially designed for flatfoot that work best for you. 
• Shockwave Therapy: This treats the tight tendons and muscles that often coincide with flat feet.
• Avoiding shoes with flat or unstructured soles, such as flip-flops and ballet flats
• Regular foot and lower limb muscle stretches:  These will strengthen the muscles so they can better withstand the extra burden placed on them by flatfoot.  They will also strengthen the ligaments responsible for holding up your foot’s arches.  Here are some great exercises and stretches you can try at home.

The foot specialists and knowledgeable staff at our foot clinic can help you find the treatment plan and supportive footwear that works best for you. 

To schedule a foot assessment appointment and treatment with our licensed Chiropodists (foot specialists), use the booking form below or call 416-769-FEET(3338).

What Are The Risk Factors For Flat Feet?

Certain risk factors may increase your chances of getting a flat foot:

• Having a hypermobile or hyperflexible foot (this is often associated with flexible flatfoot).
• Poor foot mechanics, such as overpronation leading to muscle imbalance.  
• Arthritic conditions, such as rheumatoid arthritis
• Genetics – Flat feet may run in the family
• Overuse injury, damage, or dysfunction of the posterior tibial tendon (PTTD)
• Obesity
• Pregnancy
• Age – wear and tear injuries place strain on the posterior tibial tendon and may ultimately lead to PPTD.

How Do I Prevent Flat Feet?

Although prevention is difficult, routine foot and lower limb stretches can help to strengthen muscles and reduce the risk of damage.  These include:

• Calf stretches and calf raises
• Ankle stretches (against resistance)
  • Inversion
    • Motion of turning the sole of your foot toward the midline of your body
  • Eversion
    • Motion of turning the sole of your foot away from the midline of your body
  • Dorsiflexion
    • Motion of lifting your foot upward toward the shin
  • Plantarflexion
    • Motion of lifting your foot downward toward the calf
• Plantar fascia stretches
  • Toe curls
  • Toe extensions

Check out these videos and infographics for illustrations and demonstrations of how you can reduce or prevent the effects of flatfoot.