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Have you got flat feet? | Find Your Stride

Updated: Mar 16, 2023

I hear lots of clients remark on how flat their feet are during assessments, and having seen a true flat foot in most cases they do not. I've seen thousands of 'low arches' that's for sure but to immediately label a foot flat can actually be quite alarming especially when a simple internet search will highlight all the potential problems one might have. Firstly, it's important to stare that a flat or low arched foot is not always considered abnormal and medial longitudinal arch height (the inner arch) does not have any bearing on how well a foot can function. However, in some cases a foot that rolls in excessively with most of the weight passing over the inside border may be a cause for concern.


Surgical treatment is required in the severe cases when poor alignment of the foot causes pain or fatigue, or has a high chance of doing so. These patients are considered to have a pathological flat foot. The majority of these cases respond well to a combination of muscle stretching exercises, orthoses (shoe inserts), braces and supportive footwear. If the patient doesn’t respond to conservative treatment, then surgery might be considered.



Cases of a pathological flat foot

  • Congenital (born with)

  • Tendon injuries, typically tibialis posterior (on the inside of the ankle)

  • Neurological and muscular diseases

  • Joint hypermobility

  • Abnormal joining of two bones (coalition) resulting in a rigid flat foot

  • Inflammatory Arthritis (e.g. rheumatoid arthritis)

  • Trauma or injury


Types of flat foot

Flexible

The foot is poorly aligned when a person is standing but when sitting with the weight off the foot the deformity usually corrects itself. It can be manipulated into a better position by hand.


Rigid

The foot remains in a poor position whether the person is weight bearing standing or not. It cannot be manipulated into a straight position by hand.


Diagnosis

The diagnosis is made following an examination of the foot. In certain cases, further investigations may be required such as X-ray, ultrasound, MRI or CT.


Treatment Options

Conservative care

The vast majority of patients find that they can control their symptoms with the use of non-surgical treatments. Footwear is a key factor. The correct size, width and depth of shoe are key with adequate support to hold the foot in position (laced up). You will be advised on the best shoe for your problem. Flexible footwear is to be avoided. If inadequate shoes are worn, the rest of the non-surgical treatments are unlikely to be effective over the longer term.

Often, a combination of the following options are used:

  • When active, a firmly laced, rigid sole with a cushioned inlay should be used. For example; a hiking/walking shoe

  • Special shoe inserts called orthoses

  • Cortisone injections in combination with the above treatments

  • Physiotherapy / Stretching exercises for the calf and hamstring muscles

  • Ankle braces can also be very effective in supporting the foot and improving it's position. These generally fit into shoes and can be purchased online, a company called Bauerfeind is usually my go to.


Surgical management

Surgery to correct a flatfoot can be complex and is not necessary in the majority of cases. It is only considered when a person experiences severe pain that does not improve with conservative care and occasionally in children where the deformity is severe. Cases where the position of the foot is severely affected or where the joints are very flexible (hypermobile) may be more likely to require surgical correction.


If you've been diagnosed with flat foot and remain in pain or have concerns regarding surgery either get in touch or book an appointment. We'd love to help get you right again.


Find Your Stride!

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