What does it mean to be flatfooted?

Do you have flatfeet? How can you know?

Flatfeet, or a flatfoot, is when the arches on the inside of your feet are flattened and touch the floor when you walk or stand up. Children are born with flatfeet and begin to develop an arch between the ages of three and six. Some may not develop an arch, which can remain painless as they get older, or it can begin to cause problems with their ankles, knees, hips and back. A flatfoot can also be acquired later in life and is termed adult-acquired flatfoot.

“Flatfeet, or a flatfoot, is a very treatable condition,” says Dr. Stephen Roeske, a podiatrist at Advocate Lutheran General Hospital in Park Ridge, Ill. “Initial evaluation for a flatfoot will consist of a thorough history, physical examination and X-rays to evaluate the architecture of your foot. We always begin with conservative treatment for the condition.”

“Depending on the findings, this typically means providing the lacking arch support via shoe recommendations, orthotics (medical grade over-the-counter shoe inserts vs. custom prescription orthotics) and possibly bracing,” Dr. Roeske says. “Physical therapy is often used in an effort to stretch and strengthen certain muscle groups that when tight or weak, can lead to over-pronation, resulting in a flatfoot. Only when we have exhausted all conservative treatment options do we look to surgical correction.”

Regular use of unsupportive shoes may predispose you to a flatfoot, or exacerbate an existing flatfoot. What type of shoes should you wear? In general, modern walking/ running shoes come in three main categories:

• Neutral shoes: Best for those with a neutral or high-arch foot type
• Stability shoes: Best for those with a mild or moderate flatfoot
• Motion-control shoes: Reserved for those with a moderate to severe flatfoot

If you are unsure what type of shoe will best fit your specific foot type, seek advice from a foot and ankle specialist with knowledge in lower extremity biomechanics.

An exercise program targeted at stretching and strengthening the calf/lower leg muscles is recommended throughout the treatment for a flatfoot. Exercises can include stretching of the calf/Achilles tendon, single and double heel raises, eccentric loading of the Achilles tendon and use of therabands to target certain muscle groups responsible for maintaining a healthy arch. You might be referred to a physical therapist.

In severe flatfoot cases, or for those who fail conservative treatment, flatfoot reconstruction surgery may be needed.

“If you suspect you or your child may have a flatfoot, don’t wait to get evaluated,” says Dr. Roeske. “The earlier it’s diagnosed and treated, the better the outcomes, and surgery may be avoided.”

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