Flat Feet (Pes Planus)

Flat Feet (Pes Planus)

What are Flat Feet?

Flat feet or pes planus is a condition whereby the arch along the inside of the foot is lowered or lost, causing the feet and ankle to roll inwards. It is commonly described as “pronated feet” or “excessive pronation”. Most individuals with flat feet would have gotten the condition at a young age, known as paediatric flat feet. However, an adult can also develop flat feet due to a condition called posterior tibial tendon dysfunction (PTTD).

Types of Flat Feet

There are 2 types of flat feet – flexible pes planus and rigid pes planus

Flexible pes planus occurs when the structures (bones, ligaments, and tendons) of the feet are unable to support the arch when standing or walking. However, an arch can be seen when the person is seated or lying down.

Rigid pes planus occurs when there is a structural abnormality within the foot, which result in a loss of arch regardless of standing or sitting. This can be due to:

  • Congenital deformity (e.g congenital vertical talus, skew foot, tarsal coalition)
  • Arthritis of the ankle and foot
  • Late stages of PTTD


Risk Factors of Flat Feet

Risk factors of flat feet (pes planus) include:

  • Obesity or high BMI
  • Joint hypermobility
  • Underlying soft tissue disorders (e.g Marfan’s syndrome or Ehlers-Danlos Syndrome)
  • Genetics or family history of flat feet
  • Previous ankle or foot injury (e.g ankle sprains, PTTD, Lisfranc fracture)
  • History of foot or ankle surgery
Signs and symptoms of flat feet (pes planus).

Signs and Symptoms of Flat Feet

A person with flat feet may or may not have symptoms. Symptoms are usually a result of tendon or joint stress from walking or running with flat feet.

Signs and symptoms of flat feet include:

  • Frequent tripping or ankle sprains
  • Pain under the arch
  • Pain around the ankles, especially after long periods of walking or exercising
  • Tired feet or calves
  • Calluses under the forefoot, typically around the ball of the 2nd toe
  • Excessive wear on the inner side of the shoe
Flat feet treatment with customised insoles.

Conditions Associated with Flat Feet

There are an array of conditions that can be caused by flat feet and some individuals will develop these conditions earlier than others.

Associated conditions of flat feet include:

Flat Feet Treatment

Treatment of flat feet is usually carried out to reduce the risk of developing the associated condition or as part of addressing the underlying cause of associated conditions.

Treatment options for flat feet include:

Your podiatrist should assess your condition carefully to determine the best treatment plan for you.

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