Flat feet: When is treatment required?

While some people experience no symptoms of flat feet, others suffer from painful and troublesome issues including foot, knee or hip pain, as well as shin splints or plantar fasciitis. In this informative guide, highly respected consultant foot and ankle orthopaedic surgeon Mr Paul Hamilton reveals the most common symptoms of flat feet and sheds light on the most common conservative treatment modalities. The leading specialist also reveals when surgical treatment is indicated and discusses the importance of weight control in resolving flat feet related pain.

What is meant by ‘flat feet'?

Flat feet, also known as pes planus, is a condition in which the arch of the foot collapses often causing the entire sole of the foot to collapse when standing. It is common, may be inherited and can be associated with ligament laxity or increased flexibility. In some cases, it may relate to an injury, ageing or obesity.

Flat feet can cause discomfort, not just in the feet, but also the knee and hips. Treatments should be individualised and usually include orthotics (insoles), physical therapy and on occasion, surgery.

How common are flat feet?

Flat feet are a common condition. They are more prevalent in patients with a family history of flat feet, women, people of Asian or African descent and those with associated ligament laxity. It is more common as you age and in people who are obese.

Many people with flat feet do not have symptoms or discomfort and do not need any input, living active and pain-free lives without any long-term problems or issues. It is only when flat feet cause pain and impact a person’s ability to perform activities that treatment may be considered.

In what ways can flat feet affect me?

Flat feet can cause pain and reduced function and may even be the cause of pain in other joints such as the knee. If pain does occur, it is important you seek out advice from a foot and ankle orthopaedic surgeon who can diagnose the problem and offer treatments tailored to the individual patient.

What can happen if flat feet are left untreated?

The majority of people with flat feet do not require treatment, but if symptoms do develop these may include pain in the foot, ankles, knees and hips. Some conditions associated with being flat-footed include shin splints, plantar fasciitis, Achilles tendinitis, foot fatigue and knee pain. In those who develop flat feet in middle or old age, this is often associated with tendon injuries and arthritis can develop.

How are flat feet corrected?

There are several options in the treatment of flat feet. Orthotics (often custom-made) or arch supports may reduce the pain and discomfort and help function the foot. Shoes and even braces can also be used to support and cushion the foot. Physical therapy can strengthen the muscles in the foot and lower leg and help the stability and function of the lower limb. This often includes stretching exercises, particularly of the calf muscle. In addition, weight management reduces the load through the foot and therefore can help to reduce pain.

Surgical management may be required if non-surgical treatments fail and pain increases and function deteriorates. The most suitable surgical techniques often depend on the cause and may involve tendon transfer or fusion procedures to support the foot.

If you think you may be suffering from flat feet and wish to schedule a consultation with Mr Hamilton, you can do so by visiting his Top Doctors profile.