Flat feet

In people with flat feet, sometimes referred to as "collapsed foot arch," the inside of the foot arch in both feet has collapsed. In severe cases, the arches are so collapsed that they even touch the ground, hence the term flat feet (pes planus).

How do flat feet arise?

In most cases, the cause of flat feet is congenital and therefore genetically determined. When one or both parents were born with flat feet, they can pass it on to their children.

In non-congenital flat feet, there is often an underlying disease such as joint wear (osteoarthritis), rheumatoid arthritis, or a local foot or ankle injury. Flat feet can also be caused by a nerve or muscle disease, for example, after a stroke.

Pregnant women and people with overweight or diabetes have an increased risk of developing flat feet. Older people are also more likely to have them. With age, many muscles and tendons weaken, including the tibialis muscle. This is an important supporter of the foot arch.

What are the symptoms of flat feet?

Characteristic of flat feet is the collapsed arch; as a result, the foot rolls inwards when standing and walking. This is also called overpronation of the foot and can cause pain and fatigue in the feet during prolonged standing or walking. Long-standing, untreated flat feet can, due to the altered foot position, also cause complaints in the ankle, knee, hip, and even lower back.

How is the diagnosis of flat feet made?

In "normal" feet, the distance from the ground to the inside of each foot arch is about 1.3 centimetres. In flat feet, this distance is smaller.

Flat feet are easy to establish during a physical examination, possibly supplemented with specific tests. The skin is also examined. The presence of calluses or thickenings and discolourations of the skin can provide more information about the changed position or use of the feet.

If necessary, an X-ray of the feet is taken. This can help to visualise anatomical abnormalities that may be a cause in the development of flat feet.

What is the treatment of flat feet?

Depending on the cause of the flat feet, there are several treatment options. With a structural cause, such as a congenital foot deformity or a nerve or muscle disease, it may be necessary to support the collapsed arch using orthotic insoles. These can be fitted by a podiatrist.

Other treatment options focus on reducing pain and tension on the arch. Losing weight in the case of overweight is a good first step. The physiotherapist can provide excellent guidance with therapy forms such as mobilisation techniques, taping, and forms of exercise therapy.