Flat feet: symptoms they can cause and possible treatments - medical - 2023



The average human walks 3,000-4,000 steps per day, which is equivalent to about 2.5-3 kilometers. Although this may seem like a lot, organizations focused on the study of health indicate that the most appropriate thing is to walk about 10,000 steps a day, either in the workplace or through accessory exercises. With these data, the importance of a correct structure of the feet for transport in humans is more than clear.

We are bipedal animals, that is, we use exclusively our lower extremities for locomotion. This has given our species a great facility to walk through plains, the possibility of using tools with the hands, accessibility when transporting our offspring and many other things. In short: without our feet, we would not have evolved to what we are today.

Then, What happens when there is an anatomical malformation in one or both feet? What are the effects of a locomotor dysfunction at a social and physiological level? If you want to discover the answers to these questions and many more, read on: we tell you everything you need to know about flat feet and their possible approaches.

  • We recommend you read: "The 14 types of feet (and how to identify yours)"

What are foot deformities?

According to pediatric portals, foot diseases in infants are the second reason for consulting the orthopedic surgeon after musculoskeletal pain. The human foot is essential for bipedal locomotion, so when it fails, gait and adjacent bones and muscles are compromised. The 3 most common foot deformities in young children are:

  • Clubfoot (clubfoot): instead of being located forward and having a typical shape, the clubfoot is oriented downwards, turned inwards. The toes of the affected foot "look" at the opposite leg.
  • Cavus foot: it is produced by an exaggerated increase of the plantar vault. Sometimes the toes are clawed and the heel is deviated.
  • Flatfoot: characterized by a collapse of the plantar arch.

It is this last pathology that arouses our interest today, since it is a very common disorder in infants and young children, with a general prevalence of 20% of the world population.

  • We recommend you read: "The 26 bones of the human foot (and their functions)"

What are flat feet?

As we have advanced previously, flat feet are those with a flattened plantar arch. The plantar arch is anatomically formed by 2 parts: the internal and external parts, which encompass the anterior and posterior tibial muscles, the lateral peroneus longus, the flexor of the big toe and the short plantar muscles. In addition to these muscular structures, there are ligaments such as the plantar ligament and other associated structures.

The name “flat foot” is quite self-explanatory, since the decrease in the height of the plantar longitudinal arch causes the entire sole of the foot to touch the ground when the person is standing (thus drawing a “flat” line with respect to the point support). In general, there are 2 types of flat feet. We will tell you briefly.

1. Flexible flat foot

The flexible flatfoot has a normal skeletal structure, but exhibits a lot of flexibility in its joints. Therefore, by supporting the weight on the sole, the bridge sags and the heel deviates outwards. It differs from rigid flatfoot in that, when lying down or placing the patient on tiptoe, the anatomical shape of the feet is normal. It is a relatively common condition in young children that is corrected over time, so it falls within the "normality" of development.

It is common for young children to have flat feet due to the fatty accumulations that mask the arch, which also develops from birth to 3-4 years of age. Exercising the feet during childhood with the help of physical therapists can facilitate the correct formation of the plantar arch over the years.

2. Rigid flat foot

In this case, there are abnormal joints between the bones of the foot. This causes a physiological deformity that results in a lower longitudinal arch height and a heel deviation, which is independent of the posture adopted by the patient. As it is the bones that are involved in this malformation, when changing position the situation does not improve.

There are slight variants of the rigid flatfoot depending on the damaged structures, but the general idea is clear: the situation is permanent and does not change naturally over the years, as it does with the flexible flatfoot.

What symptoms do flat feet cause?

Most people have no symptoms associated with flat feet. In addition, it should be noted that there is no marked reduction in the speed of movement, nor does it affect the plantar reflex in any way.

But nevertheless, some people may experience pain in the foot, ankle, or lower leg. In older patients, it is common for the feet to become arched or tired after a long standing session or after playing sports. Although not very common, it is also possible to experience pain in the outer section of the ankle, which will appear swollen.

Remember that approximately 15% of adult humans have flexible flat feet. If this deformity caused very serious symptoms, the social limitations and the number of interventions would multiply exponentially. Luckily, the most common is that pain is not experienced and the functional limitation is null, so no medical intervention is necessary.

Possible treatments

As we have said multiple times, no medical approach is necessary if the patient is not in pain. In addition, it is essential to elucidate whether the patient has a flexible or a rigid flat foot, since the clinical approach will change in the face of both events.

In the case of a flexible flatfoot in infants, the plantar arch is most likely to develop correctly over time. For it to acquire its final shape, there must be a slow but uninterrupted growth of the muscles, tendons, ligaments and bones involved: it is not necessary to be in a hurry, since evolution has provided us with the relevant mechanisms to acquire an optimal physiology (except for a few occasions).

Anyway, some people choose to put special shoes, inserts, orthotics, or wedges on their children. It can also be useful to encourage the infant to walk barefoot on uneven ground such as sand or grass, as it encourages a correct development of the plantar arch. Discuss all the options listed here with your child's pediatrician before making any decision on your own, otherwise, the only thing you are going to achieve is to worsen the clinical picture.

Rigid flat feet, on the other hand, require a completely different approach. These will not improve with exercises or the passage of time (since it is a bone condition), so sometimes it is necessary to go to surgery. Some of the most common procedures performed are as follows:

  • Surgery to clean or repair the involved tendon.
  • Transfer of a tendon to regain the normal shape of the plantar arch.
  • Merge some of the joints of the foot into a corrected position.

In addition to all this, it is also necessary to emphasize that flat feet in older adults can be treated with pain relievers, orthotics, and the previously mentioned procedures. Surgery often improves pain and function of the foot for those who need it, although there are some complications that should be discussed with the medical professional before and after the operation.


Beyond the medical data, you will have been able to verify that flatfoot is a much more common clinical entity than you might initially believe. 15-20% of the world's population suffers from it And yet very few people require surgery. Flat feet are often painless and almost never cause functional or motor impairment.

If you are reading this because you have a child with flat feet, don't worry. The plantar arch takes time to develop, and requires exercise and physical activities to present the proper anatomical structure.