Flatfoot

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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, and the condition occurs in both children and adults. Most children are flat-footed until they are between the ages of three and five, when the longitudinal arch typically develops.

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

People who have flat feet rarely have symptoms or problems, though some people with flat feet may experience pain because of:

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

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

Treatment in adults generally consists of wearing spacious, comfortable shoes with good arch support. Your doctor may recommend padding for the heel (heel cup) or orthotic shoe devices, which are molded pieces of rubber, leather, metal, plastic or other synthetic material that are inserted into a shoe. These devices balance the foot in a neutral position and cushion it from excessive pounding. Surgery is rarely needed.

For children, treatment using corrective shoes or inserts is not often necessary, as the arch usually develops normally by age five.

You may be able to relieve associated heel pain by stretching tight calf muscles. To stretch calf muscles: 

• Stand about one foot from a wall and place the palms of both hands against the wall at chest level.
• Step back with one foot, keeping that leg straight at the knee and both feet flat on the floor. Feet should point directly to the wall or slightly in toward the center of your body. Keep the knee of the leg nearest the wall centered over the ankle.
• Bend your other (front) leg at the knee, and press the wall with both hands until you feel a gentle stretch on your back leg (calf muscle).
• Hold for a count of ten (increasing the count to 30 or longer as you continue over several weeks). Switch legs and repeat. Do this two to four times a day.

Foot-strengthening exercises can be done with a towel and weights. To do so:

• Place a towel on the floor, and sit in a chair with both feet resting flat on the towel at either end.
• Grip the towel with the toes of one foot while keeping your heel on the floor. Use your other foot to anchor the towel. Curl the gripped toes to pull the towel up toward you.
• Repeat with the other foot. To increase strength, later use three pound to five pound weights (or a large can of fruit or vegetables) on the other end of the towel.

Calf-stretching exercises can be done with a towel. To do so:

• Sit on the floor or on a mat with your feet stretched out in front of you.
• Roll up a towel lengthwise, and loop it over one foot around the ball of the foot.
• Take each end of the towel in either hand and gently pull the towel toward your body to stretch the front of your foot. Repeat with the other foot.

Some people—especially competitive athletes, those wanting to return to a strenuous sports program or those highly motivated to address flatfoot—may choose more intensive strengthening and flexibility programs. A physical therapist or trainer can help supervise a program recommended by a sports medicine specialist or foot specialist, such as an orthopedist or podiatrist.

Treatment with nonsteroidal anti-inflammatory drugs (NSAIDs), heat or massage may help with foot pain and leg discomfort. If flatfoot is related to another condition, surgery or other treatments may be needed.