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St. Mary's Center for Orthopaedics

Flatfoot (Pes Planus)

What is Flatfoot?

Flatfoot (pes planus) is a condition in which the longitudinal arch in the foot, which runs lengthwise along the sole of the foot, has not developed normally and is lowered or flattened out. One foot or both feet may be affected.

What Causes Flatfoot?

Flatfoot may be an inherited condition or may be caused by an injury or condition such as rheumatoid arthritis, stroke, or diabetes.

Who is Affected by Flatfoot?

Children as well as adults may be flat-footed. Most children are flat-footed until they are between the ages of 3 and 5 when their longitudinal arch develops normally.

What are the Symptoms of Flat Feet?

Symptoms of flat feet include:

  • One or both feet having a flat appearance to them
  • The uneven wearing of shoes in the arch support area.
  • Pains in the calf or lower leg.
  • Pain and swelling of the ankle area typically on the inside of the ankle.
  • General foot pain and discomfort especially after long walks or standing for long durations

Some people may have pain because of:

  • Changes in work environment.
  • Minor injury.
  • Sudden weight gain.
  • Excessive standing, walking, jumping, or running.
  • Poorly fitted footwear.

Children sometimes have foot discomfort and leg aches associated with flat-footedness.

How are Flat Feet Diagnosed?

During the physical exam, the doctor will observe your feet from the front and the back and ask you to stand on your toes so the mechanics of your feet can be viewed. The doctor may also want to look at the wear pattern on your shoes.

Imaging Tests
If you’re having a lot of pain in your feet, the doctor may order tests such as:

  • X-rays. A simple X-ray uses a small amount of radiation to produce images of the bones and joints in your feet. It’s particularly useful in detecting arthritis.
  • Computerized tomography (CT scan). This test takes X-rays of your foot from many different angles and provides much more detail than a standard X-ray.
  • Ultrasound. If your doctor suspects an injured tendon, he or she may request an ultrasound test — which uses sound waves to produce detailed images of soft tissues within the body.
  • Magnetic resonance imaging (MRI). Using radio waves and a strong magnet, MRIs provide excellent detail for both hard and soft tissues.

How are Flat Feet Treated?

Treatment with anti-inflammatory medication, heat, or massage may help with foot pain and leg discomfort. If flatfoot is related to another condition, surgery or other treatment may be needed. No treatment is necessary for flatfeet if you aren’t experiencing any pain.

If your flat feet are painful, your doctor might suggest:

  • Arch supports (orthotic devices). Over-the-counter arch supports may help relieve the pain caused by flatfeet. Or your doctor might suggest custom-designed arch supports, which are molded to the contours of your feet. Arch supports won’t cure flatfeet, but they often reduce symptoms.
  • Stretching exercises. Some people with flatfeet also have a shortened Achilles tendon. Exercises to stretch this tendon may help.
  • Proper shoe wear. A structurally supportive shoe may be better tolerated than sandals or shoes with minimal support.

Surgery is not performed solely for the purpose of correcting flat feet. Surgery may be performed for an associated problem such as a tendon tear or rupture.