Are flat feet abnormal?

Feet are built in all different shapes and sizes. Flat feet refers to loss of the height of the arch on the inner side of your foot.  There is a spectrum from very flat arches to high arched feet.  Most flat feet are normal and people are born that way rather than developing flat feet later on.   This simply reflects the way you were put together and the genes that have been passed on to you. For this reason most people do not need treatment. Many world class sports stars have flat feet.

Some flat feet, however, are abnormal and need further investigation.

Should I be worried?

If your feet, or your child’s feet are painful then you should seek an orthopaedic opinion.

Sometimes flat feet in children can become stiff and painful because some of the bones don’t separate normally (coalition). In adults who suddenly develop a flat foot, a common cause is a tendon rupture (posterior tibial tendon). Sometimes advanced arthritis can cause joint instability and a flat foot.

Posterior tibial tendon dysfunction.

This is a strong tendon that runs around the inner side of the ankle and helps support the arch of the foot. It is also important in controlling the heel position at push-off when you are walking.  If the tendon becomes painful and inflammed a shoe insert or brace may be helpful.  In more advanced cases the tendon may tear and lose all its function.  This may still be treated with a brace but is more likely to require an operation to straighten the heel (calcaneum osteotomy) and replace the torn tendon with another transferred from under the foot. If the problem has been left for many years, the foot can become stiffened in the flat position with arthritis in some joints requiring a fusion operation.