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Flat feet: Symptoms, Causes and Risk factors

Flat feet is also known as fallen arches. When young children have no arches, then this condition is not visible because baby has soft tissue in its feet and it has baby fat. This term is used for the condition in which you have low arches or no arches and in this condition your feet press almost completely flat against the ground. People are having flat feet when the arches on the inside of their feet are flattened which is allowing the entire soles of their feet to touch the floor when they stand up. This is a very common condition and in the most cases it is painless. When the arches are not developing in your childhood, then this condition is happening. [1] Also there are other cases in which flat feet are developing from the simple wear and tear stresses of age or after an injury. [2] Also there are some cases in which this condition can be result from problems to your knees and ankles because flat feet can alter the alignment of your legs. If you do not have any kind of pain in your feet, then you may not have a need to make some kinds of treatments.

Symptoms: In the most cases when people suffer from flat feet, they do not feel any kind of sign or symptom which is associated with this condition. But also there are some people who can have foot pain, particularly in the arch or heel area. When they are making some activities, then their pain can get worse. Also the swelling along the inside of the ankle can happen. If you have noticed that you have a foot pain or your child has a foot pain, then you should talk with your doctor as soon as possible.

Is flat feet a problem?

In the most cases people who have flat feet should not worry about it. Many people who have flat feet are not having any other kind of problem which means that they do not have to use any kind of treatment. In some cases flat feet can be associated with:

  • When they have an underlying problem with the bones, muscles or connective tissues in and around the feet
  • Pain in the feet, ankles, lower legs, knees, hips or lower back
  • The feet rolling inwards too much (overpronation) – this can cause shoes to wear out quickly and lead to injuries

Causes: In the most cases people inherit this condition from their parents. Infants and toddlers can have flat feet which is normal for them because their arch is not yet developed. [3] In the most cases arches are developing throughout childhood but also there are some people who never develop arches. This is a normal variation of foot type. People without arches may have foot problems or they may not have. There are some children who have flexible flatfoot [3]. This is a condition in which the arch is visible when the child is standing on tiptoes or it is sitting. But when the child stands, then it disappears. In the most cases children outgrow this condition without having any problem. Also arches can fall over time. If you have wear and tear with years, then this can weaken your tendon. Tendon runs along the inside of your ankle and which gives support to your arch. There are some occasional cases in which flat feet can be the result of:

Flat feet: Symptoms, Causes and Risk factors

  • The connective tissue in the foot becoming stretched and inflamed – possibly as result of overuse, unsupportive footwear, an injury, increasing age, obesity or rheumatoid arthritis [4]
  • A condition affecting the muscles and nerves such as cerebral palsy, spina bifida or muscular dystrophy
  • When they have loose connective tissue throughout the body such as in Ehlers – Danlos syndrome or joint hypermobility syndrome [5]
  • The feet bones not forming properly in the womb

Risk factors: There are some factors which can increase your risk of getting flat feet such as

  • Diabetes [6]
  • Aging
  • Rheumatoid arthritis [7]
  • Injury to your foot or ankle [2]
  • Obesity [8]

If you have some underlying condition for the flat feet, then you need some kinds of treatments. If you are feet are painful even when you are wearing supportive, well – fitting shoes, then you should visit your doctor as soon as possible. Also if you have noticed that your feet appear to be getting flatter, then you should seek medical help.


[1] Ezema CI, Abaraogu UO, Okafor GO. Flat foot and associated factors among primary school children: A cross-sectional study. Hong Kong Physiotherapy Journal. 2014;32(1):13-20.

[2] Michelson JD, Durant DM, McFarland E. The injury risk associated with pes planus in athletes.Foot & Ankle International. 2002;23(7):629-33.

[3] Banwell HA, Paris ME, Mackintosh S, Williams CM. Paediatric flexible flat foot: how are we measuring it and are we getting it right? A systematic review. Journal of Foot and Ankle Research. 2018;11.

[4] Holowka NB, Wallace IJ, Lieberman DE. Foot strength and stiffness are related to footwear use in a comparison of minimally- vs. conventionally-shod populations. Scientific Reports. 2018;8:3679.

[5] Castori M. Ehlers-Danlos syndrome, hypermobility type: An underdiagnosed hereditary connective tissue disorder with mucocutaneous, articular, and systemic manifestations. ISRN Dermatology. 2012;2012:751768.

[6] Pita-Fernandez S, Gonzalez-Martin C, Alonso-Tajes F, et al. Flat foot in a random population and its impact on quality of life and functionality. Journal of Clinical and Diagnostic Research. 2017;11(4):LC22–LC27.

[7] Gross D, Felson DT, Niu J, et al. Flat feet are associated with knee pain and cartilage damage in older adults. Arthritis Care Research (Hoboken). 2011;63(7):10.1002/acr.20431.

[8] Stolzman S, Irby MB, Callahan AB, Skelton JA. Pes planus and pediatric obesity: A systematic review of the literature.
Clinical Obesity. 2015;5(2):52–9.

Dr. Emil Sarsath (aka) Vijila, a licensed naturopathic doctor (BSMS) who always ensures his patients receive compassionate, and individualized care. He has extensive experience in primary care, digestive health, mental health, nervous system disorder and more.Area of Expertise – Naturopathic Medicine, Whole Foods-based Nutrition, Siddha, Panchakarma.She is always available through [email protected]


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