Flat feet are one of the most common conditions of the foot. It is normal for infants and children to have flat feet, but as the child grows a normal arch should develop. Flat feet are often associated with overpronation, which is when the ankle bends inwards. This can be seen in shoes where the inner part of the heel wears out faster or the shoes 'leans' inwards.
People with flat feet do not always experience pain. However, some common symptoms of flat feet can include tired feet, ankle pain, knee pain, or even lower back pain. People with flat feet are also more likely to develop conditions like bunions.
Typically, flat footedness is hereditary but there are instances where people develop a flat foot. In adults, there is a condition where the tibialis posterior tendon becomes weakened called posterior tibial tendon dysfunction (PTTD). When this happens the tendon becomes inflamed, weakened and can tear or rupture. As the condition progresses there will be pain along the tendon and the arch will gradually get lower.
Since there is no cure for flat feet, treatment is focused on supporting the foot. Typically structured footwear is recommended and custom orthotics are prescribed to support the arch and prevent the foot from overpronating. The flatter the foot, the more support and correction may be necessary. Children with flat feet may be prescribed orthotics if the child has a normal heel to toe gait, the foot has adequately developed and there is a family history of flat feet.
In cases of PTTD, when footwear and custom orthotics are no longer providing adequate support or pain relief, anti-inflammatories and ankle-foot orthoses (AFOs) may be prescribed. In very severe cases, surgery may be necessary.