Flatfoot: Symptoms, Causes, Treatment & Pictures

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.

Symptoms of Flatfoot

Flatfoot can be apparent at birth or it may not show up until years later. Most children with flatfoot have no symptoms, but some have one or more of the following symptoms:

• Pain, tenderness or cramping in the foot, leg and knee
• Outward tilting of the heel
• Awkwardness or changes in walking
• Difficulty with shoes
• Reduced energy when participating in physical activities
• Voluntary withdrawal from physical activities

Diagnosis of Flatfoot

If your child continues to have flat feet after the age of 10, his or her doctor will perform a physical examination to determine what type of flat feet your child has. The doctor will have your child stand on the whole foot called the “loaded” position and on the toes. In addition, the doctor will check the shape of the foot when your child gets off the foot (the “unloaded” position) as well as how far your child can bend the foot at the ankle.

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.

Nonsurgical Treatment for Flatfoot

If a child has no symptoms, treatment is often not required. Instead, the condition will be observed and reevaluated periodically by the foot and ankle surgeon.

Custom orthotic devices may be considered for some cases of asymptomatic flatfoot.

When the child has symptoms, treatment is required. The foot and ankle surgeon may select one or more of the following nonsurgical approaches:

• Activity modifications. The child needs to temporarily decrease activities that bring pain as well as avoid prolonged walking or standing.
• Orthotic devices. The foot and ankle surgeon can provide custom orthotic devices that fit inside the shoe to support the structure of the foot and improve function.
• Physical therapy. Stretching exercises, supervised by the foot and ankle surgeon or a physical therapist, provide relief in some cases of flatfoot.
• Medications. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be recommended to help reduce pain and inflammation.
• Shoe modifications. The foot and ankle surgeon will advise you on footwear characteristics that are important for the child with flatfoot.

Flatfoot Pictures