What are the causes of flat feet?

Flat feet can be caused by either congenital or acquired factors. Congenital factors that lead to flat feet include:

  • Congenital tarsal coalition, in which the child has congenital tarsal coalition such as calcaneus and talus coalition. This is a common situation where there is a greater chance of developing flat feet;
  • Congenital loosening of the ligament, which means the child suffers from congenital loosening of ligaments throughout the body. This condition of loosened ligaments can appear on the feet or other body joints, and it is also one of the reasons for the foot arches to disappear;
  • The foot arches in children under eight years old are yet fully developed. As the Achilles tendons and ligaments are softer, chance of causing flat feet would be higher; and
  • Genetic factors. If the parents or other members of the family have flat feet, there will be a greater chance for the child to suffer from the same condition.

Even if the arches on the inner side of the feet were born normal, there may still be acquired factors that lead to disappearing of healthy foot arches. These causes include:

  • Damage to the posterior tibial tendon, that is one of the common causes of adult acquired flatfoot. Posterior tibialis tendinitis is more often seen in middle-aged lady. Overuse and trauma can cause inflammation of the tendon. Patients with this condition usually complain of pain along the inside of the foot and ankle where the tendon lies. If left untreated, the medial foot arch may become flattened and the flat foot deformity will become rigid and lead to painful degeneration.
  • Overweight of the body may over-burden the foot arches, making them unable to bear the relevant body weight and result in flat feet
  • Due to the lack of exercise, the muscles of the feet are not strong enough to support the body, while the elasticity of the foot arches may not be sufficient either; and
  • Accidental injuries may also lead to acquired loosening of the ligaments.
What are the symptoms of flat feet?

Flat feet generally show no obvious symptoms during the initial stage. In terms of appearance, however, the foot arches will collapse and lead to flat soles. If it is found that the space between the foot arches and the floor is not enough to fit a pen when a person stands on the ground with bare feet, further examination should be considered.

Other symptoms include frequent tiredness on the inner side of the feet while walking or after exercise, more wearing on the inside of the shoe heels, more frequent callus, and the feet splaying inward or outward during walking.

In case proper treatment is not given to alleviate the condition of flat feet, prolonged walking or standing may lead to complications such as inflammation of the plantar fascia and spur proliferation.

Can flat feet be treated?

Generally, foot arches develop before the age of eight. Since the arches have not been fully developed and the Achilles tendons and ligaments are still soft during this age, many children suffer from physiological flat feet. After the age of eight, the development of the foot arches will complete with the increase of age. Under most circumstances, this will bring about improvement of the flat feet condition. If the child is in a more serious condition, physiotherapy or the use of orthopaedic insoles may be necessary.

For adults who suffer from the problem of flat feet, doctors may recommend them to use insoles to improve the shape of the foot and prevent consequences due to the collapse of foot arches. Meanwhile, physiotherapy is another possible treatment. For cases with serious pain, anti-inflammatory analgesics may be given. Only a very small number of cases require surgical intervention.

How to prevent flat feet?

1. Foot exercises
To prevent flat feet, you can regularly exercise your feet through rope-skipping and standing on your toes. These exercises can strengthen the thighs, calves, plantar muscles, tendons and ligaments. You may also stretch the toe tendons and press the plantar fascia with your elbows to stretch the foot arches.

2. Choose the right shoes
When choosing shoes, you should pick those with a right size and breathable style. In addition, the soles need to be tough enough to support the arch, prevent slip, and absorb shock. Meanwhile, the heels of the shoe need to provide sufficient support to prevent injury to the calcaneus. Meanwhile, avoid wearing pointed style shoes and high heels above two inches.。

3. Regular examination
Children who are still in the developmental stages or who are suspected of having flat feet can undergo regular foot assessments or perform foot stress tests to check and follow up on the development of the foot arches.

4. Healthy lifestyle
Live a healthy lifestyle to maintain normal weight and avoid overburdening the feet which would help prevent flat feet.

Last Updated: Nov 2019
Please note that all medical health articles featured on our website have been reviewed by Quality Healthcare doctors. The articles are for general information only and are not medical opinions nor should the contents be used to replace the need for personal consultation with a qualified health professional on the reader’s medical condition.