Treating Flat Feet: From Orthotics To Surgery

Treating Flat Feet: From Orthotics To Surgery

Flat feet, commonly called fallen arches, describe a condition where the foot’s arch either collapses or never fully develops, resulting in the entire sole making contact with the ground. It’s estimated that about 20% of adults exhibit this condition, affecting both sexes and individuals of all ages.

While having flat feet doesn’t always cause problems, in certain situations, it might lead to pain, challenges in walking, or even other related foot issues. Several treatment options have been developed to help correct the condition. This article discusses the options available for treating flat feet. It offers a comprehensive guide, from non-surgical solutions like orthotics to surgical procedures. You can also learn more about the anatomy and the complications of feet.

Anatomy Of The Foot

The human foot consists of three distinct arches that support body weight and facilitate movement. When one or more of these arches collapses, it leads to the condition known as flat feet, altering the foot’s structure and potential.

Types Of Flat Feet

There are two major types of flat feet. They are:

  • Flexible Flatfoot

Flexible flatfoot is commonly observed in children and often corrects itself as they grow and develop. However, it may still require monitoring to ensure that the arches develop correctly and that no further issues arise as the child matures.

  • Rigid Flatfoot

Rigid flatfoot is generally more serious and may require intervention, including physical therapy or surgery. It’s characterized by a persistent lack of arch, even when the foot is not bearing weight, and requires a comprehensive treatment approach to manage effectively.

Causes Of Flat Feet

Flat feet can develop suddenly or gradually over the years. The causes can include the following:

  • Genetic Factors

Some individuals inherit flat feet from their family, making it a hereditary condition present from birth. This genetic predisposition means that children with parents who have flat feet are more likely to develop the condition themselves.

  • Injuries Or Illnesses

Trauma to the foot or ankle, or illnesses affecting the muscles and nerves, can cause the arches to collapse, resulting in flat feet. It’s vital to address these underlying causes with proper medical care to prevent or manage flat-footedness.

  • Obesity

Carrying extra weight puts immense pressure on the arches of the foot, and this additional stress can cause them to collapse. Managing body weight through a healthy diet and regular exercise is a proactive measure against developing flat feet due to obesity.

Healing therapy. Happy red haired woman laughing out loud while sitting at the sofa and talking with her doctor during therapy. Mental health concept

Symptoms And Diagnosis

The common symptoms of flat feet include

  • Pain In The Feet: Flat feet can cause pain in the feet, ankles, knees, or hips. The pain is usually caused by the strain on the muscles and ligaments of the foot as they try to compensate for the lack of arch support. Pain in the knees and hips can also be caused by flat feet as the body adjusts its gait to compensate for the lack of arch support.
  • Fatigue In The Feet: Flat feet can cause fatigue in the feet, especially after prolonged standing. This is because the muscles and ligaments of the foot have to work harder to support the body’s weight.
  • Difficulty Walking Or Running: Flat feet can make it difficult to walk or run, especially for long distances. The lack of arch support can make the foot unstable and prone to rolling inward.
  • Swelling In The Feet: Flat feet can cause swelling in the feet, especially after prolonged standing or walking. This is because the extra weight on the foot causes fluid to accumulate in the tissues.
  • Instability In The Ankles: Flat feet can make the ankles unstable, leading to sprains and other injuries. This is because the lack of arch support does not give the ankle the support it needs to move properly.

If you are experiencing any of these symptoms, seeing a doctor for diagnosis and treatment is important.

Non-Surgical Treatment Options

Treating flat feet doesn’t always require surgery. Various non-surgical approaches can be highly effective, depending on the severity and type of flat feet.

  1. Orthotics

Orthotics is one of the primary non-surgical treatment options for flat feet. They’re essential for treating flat feet, as they offer support, alignment, and often provide relief from discomfort. They are devices inserted into shoes to correct an abnormal or irregular walking pattern. Using orthotics for flat feet treatment can be broadly categorized into two main types: custom-made and over-the-counter.

Custom-made orthotics are uniquely designed to fit an individual’s foot, providing specific support and alignment. These are crafted by healthcare professionals like podiatrists who perform a detailed foot examination. While they are generally more expensive, custom-made orthotics are tailored to a person’s feet to provide optimal comfort and efficacy.

On the other hand, over-the-counter orthotics are pre-made inserts available in various sizes and shapes. While less precise than custom-made options, they are more affordable and widely accessible. Over-the-counter orthotics may be effective for minor cases of flat feet, but consulting with a healthcare provider ensures the right fit and suitability.

  1. Physical Therapy

Physical therapy offers a comprehensive approach to treating flat feet, focusing on strengthening the muscles, tendons, and overall structure of the foot. It is usually performed by trained physical therapists who design individualized programs to improve foot alignment and function.

Exercises form a core part of physical therapy for flat feet, targeting specific areas that need strengthening. Consistent practice and adherence to the therapist’s instructions are crucial for success. Stretching techniques, another component of physical therapy, are aimed at relieving tension and increasing the flexibility of foot muscles and tendons. Regular stretches guided by a skilled therapist can enhance overall foot function.

Additionally, manual therapy, which involves hands-on manipulation and massage by a skilled therapist, can be employed. Manual therapy can improve mobility, relieve pain, and enhance foot function by addressing alignment and muscular imbalances. Collaboration with a skilled therapist and combining these techniques often yield the best results in managing flat feet.

  1. Medication And Pain Management

Medication and pain management is often supplementary approach in treating flat feet. Over-the-counter pain relievers and anti-inflammatory drugs can alleviate discomfort and swelling associated with the condition. While medication can be quite helpful in managing symptoms, it’s typically not a standalone solution.

Medication should be used under healthcare professionals’ guidance to avoid potential side effects and interactions. It is generally most effective with other methods like orthotics or physical therapy. Consistent monitoring and follow-up with a healthcare provider ensure medication is used safely and effectively in a broader flatfoot treatment strategy.

  1. Lifestyle Changes

Lifestyle changes can profoundly impact the management and treatment of flat feet. Weight management is crucial, as excess weight can exacerbate the strain on the feet. A well-balanced diet, regular exercise, and maintenance of a healthy weight can significantly reduce the pressure on the foot arches, alleviating symptoms of flat feet.

Proper footwear is another vital aspect of lifestyle modification for flat foot management. Shoes with proper arch support, cushioning, and fit can provide essential comfort and support. Consulting with specialists, such as podiatrists, ensures that individuals select the best footwear for their specific condition. High-quality shoes designed for an individual’s needs can greatly enhance comfort, function, and overall foot health.

Surgical Treatment Options

Surgical intervention for flat feet is considered when non-surgical options are insufficient, or the condition becomes severely debilitating. Understanding when to opt for surgery, the different surgical options, the recovery and rehabilitation process, and the potential risks and complications are critical for anyone considering this treatment route.

Pain, deformity, dysfunction, or damage to the foot may necessitate surgical intervention. An in-depth consultation with a foot specialist helps determine if surgery is the right option based on symptoms, lifestyle, activity level, and overall health.

Types Of Surgery

There are four main types of surgery for flat feet. These surgical options represent different approaches to treating flat feet, each with specific applications, benefits, and limitations. They include:

  1. Arthrodesis

Arthrodesis is a surgical procedure involving bone fusion within a joint to eliminate movement. In the context of flat feet, arthrodesis is employed to realign deformed joints, providing stability to the foot. The fusion of bones relieves pain and corrects deformities, improving functionality and alleviating discomfort.

However, the procedure results in limited joint movement due to the fusion of bones. This lack of mobility might lead to difficulties in certain activities, so understanding this consequence is vital. The decision to perform arthrodesis should be taken after thoroughly examining the patient’s specific condition and needs.

  1. Osteotomy

Osteotomy is a procedure involving the cutting and reshaping of specific bones in the foot to correct deformities. By repositioning these bones, the surgeon can restore the natural arch and alignment of the foot, often relieving pain and discomfort associated with flat feet.

This surgery requires precise planning and execution by skilled orthopedic surgeons. It may also be combined with other surgical techniques to achieve the desired outcome, depending on the complexity of the patient’s condition. Post-surgical recovery and rehabilitation are essential to ensure the success of an osteotomy.

  1. Tendon Transfer

In a tendon transfer procedure, the force of a tendon is redirected to enhance the foot’s function. This involves utilizing a healthy tendon to replace a damaged or non-functioning one, improving foot alignment and balance. Tendon transfer can be a solution for patients whose flat feet stem from muscle or tendon dysfunction.

This surgery is complex and often used in combination with other procedures. Careful assessment by an orthopedic specialist, followed by a specialized rehabilitation program, is essential to optimize the results of a tendon transfer. The individualized approach ensures that the patient’s unique needs are addressed.

  1. Arthroereisis

Arthroereisis is a less invasive surgical procedure involving inserting a small implant into the foot. This implant blocks abnormal motion and supports the arch, often used for more flexible flat feet or in pediatric cases. It provides a way to correct the deformity without permanently altering the foot’s structure.

The reversible nature of arthroereisis makes it an attractive option for those who may not need permanent surgical alteration. A comprehensive evaluation by a foot specialist and close monitoring during recovery can maximize the benefits of arthrodesis and ensure that it is the appropriate solution for the patient’s particular case.

Recovery And Rehabilitation

The recovery time after surgery for flat feet varies depending on the type of surgery that is performed. Arthrodesis typically has the longest recovery time, followed by osteotomy. Tendon transfer and arthroereisis have shorter recovery times.

During recovery, it is important to follow your doctor’s instructions carefully. You will likely need to wear a cast or boot for several weeks. You may also need to use crutches or a walker to get around. Physical therapy will help you regain your strength and range of motion.

Pediatric Considerations

Flat feet in children are a common condition that requires careful attention and management. Addressing this issue early can prevent complications and improve the child’s overall well-being and development.

  • Recognizing Flat Feet In Children

Recognizing flat feet in children can be challenging, as many children naturally have flat feet that often correct themselves as they grow. However, persistent flat feet may lead to discomfort and other issues.

Symptoms such as pain, difficulty walking, or abnormal shoe wear patterns can be telltale signs. Regular check-ups with a healthcare provider can aid in early detection. Parents should also be vigilant in observing their child’s gait and footwear, as these observations can be crucial in identifying a problem early on.

  • Treatment Approaches

When treating flat feet in children, non-invasive strategies are typically the first line of approach. Orthotics, physical therapy, and proper footwear may be sufficient.

A podiatrist or orthopedic specialist could recommend custom-made orthotics or specialized physical therapy programs in more severe instances. Collaboration with healthcare providers ensures an individualized treatment plan that addresses the child’s needs and symptoms.

It’s also essential to recognize that children’s needs may change as they grow. So regular monitoring and potential adjustments to the treatment approach may be necessary.

  • Long-term Management And Monitoring

Long-term management and monitoring of flat feet in children are vital to ensure ongoing comfort and proper foot development. Regular evaluations by healthcare providers can detect any changes or developments that might require alterations in treatment strategies.

Parents and caregivers should also maintain awareness of any complaints or signs of discomfort from the child. Encouraging healthy habits such as maintaining an active lifestyle, wearing appropriate footwear, and engaging in foot-specific exercises can contribute to long-term well-being. Close collaboration between healthcare providers and caregivers ensures continuous support and effective management of flat feet throughout childhood.


Whether in adults or children, addressing flat feet necessitates a comprehensive understanding and tailored approach. Each treatment offers unique benefits catered to individual needs, from non-invasive methods like orthotics and physical therapy to surgical interventions.

Children, in particular, benefit from early detection and long-term management, ensuring their feet develop healthily. Ultimately, a proactive and informed approach to flat feet can improve well-being and a lifetime of comfort and mobility.


Anna is an avid blogger with an educational background in medicine and mental health. She is a generalist with many other interests including nutrition, women's health, astronomy and photography. In her free time from work and writing, Anna enjoys nature walks, reading, and listening to jazz and classical music.

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