Flat feet

 Background

Flat feet are very common affecting up to 1 in 5 of the population. Most young children have flat feet as the arches do not develop before 10 years old. ‘Abnormal’ flat feet are considered to be present only after 10 years and if they are severe and painful. The condition is even more common in the UAE.

There are three main types:

1. Flexible flat feet are the most common.

2.  Fixed, uncorrectable flat feet in children/young adults often have an underlying mechanical problem.

3. Flat feet in adults that were previously normal may have tendon damage on the inside of the foot (this tendon helps maintain the arch).

 

What causes it?

Many patients with flat feet have family members affected as there is a strong genetic link. Being overweight can cause some of the adult onset flat feet.

 

What happens with no treatment?

The vast majority of patients with flat feet have little or no pain. Studies have shown that non-painful flexible flat in children should not have orthotics (insoles) as it makes no difference to arch development.

Teenage children during a growth spurt commonly have some activity-related pain. This pain commonly reduces once growth stops in early adulthood.

Adult onset flat feet are most painful when one of the foot tendons becomes damaged and begins stretching. The pain can settle on its own (but can take many months).

 

Treatment options

 Once the cause of flat footedness has been diagnosed, the initial treatment in all patients is orthotics (Insoles). If the feet are flexible a corrective insole is given (to correct the deformity and support the arch). If it is fixed, an accommodative insole is given (spreads the load to non-painful areas of the foot). These should be worn for at least 3 months before deciding how effective they are.

If pain remains very significant then surgery can be considered. There are many surgical options and it very much depends on the type of flat foot you have plus your age.