flat feetFlatfoot is often a complex disorder, with diverse symptoms and varying degrees of deformity and disability. There are several types of flatfoot, all of which have one characteristic in common: partial or total collapse (loss) of the arch.


Not everyone with flat feet experiences symptoms. But those who do report the following problems.

  • feet get tired easily
  • aches and pain in the arches or heels
  • bottoms of the feet become swollen
  • standing on toes is hard
  • back, hip, and leg pain

runnersRisk Factors

  • athletes with foot and ankle injuries
  • genetics - flat feet are inherited
  • aging
  • pregnancy
  • obesity
  • diabetes
  • hypertension
  • rhematoid arthritis

Types of Flatfoot

flat feet can lead to heel pain Flexible flatfoot

Flexible flatfoot is one of the most common types of flatfoot. It typically begins in early childhood and continues into adulthood. Children are born with flat feet but usually outgrow them by the time they are five or six. If they don't then they have developmental flat foot. This type of flatfoot remains into adulthood and is called flexible flatfoot. It usually occurs in both feet and progresses in severity into later life. As the deformity worsens, the soft tissues (tendons and ligaments) of the arch may stretch or tear and can become inflamed. The term “flexible” means that while the foot is flat when standing (weightbearing), the arch returns when not standing.

Flexible flatfoot can lead to the following symptoms and conditions:

  • Ankles that roll in or pronate
  • Shin splints
  • Plantar fasciitis, Achilles tendonitis, bunions, and hammertoes
  • Aching or fatigue in the foot or leg
  • Low back, hip, knee, ankle pain, and migraines

Posterior tibial tendon dysfunction

Posterior tibial tendon dysfunction (PTTD) refers to inflammation of the tendon of the tibialis posterior. This condition arises when the tendon becomes inflamed, stretched, or torn leading to a collapsing arch. Left untreated, it may lead to severe disability and chronic pain. Risk factors for this condition are obesity, diabetes, and hypertension.

Rheumatoid arthritis

Rheumatoid arthritis is an immune disorder that can cause the arch to collapse. The faulty immune system attacks the joints and the ligaments that support the foot.


People who were involved in sports are also at risk for developing flat feet. Injury to the ligaments of the foot can cause those ligaments to lose their ability to maintain the shape of the foot resulting in a collapsed arch.

Charcot Foot

Charcot Foot is a form of arthritis that often develops suddenly and without pain, primarily in diabetic patients. Without any warning, the bones in the foot and/or ankle spontaneously fracture and fragment, often causing severe deformity. The arch of the foot often collapses, and pressure areas develop on the bottom of the foot, leading to open sores or ulcers.

Diagnosing Flat Foot

Your podiatrist will check your health history, watch you walk, check your shoes for wear patterns, test your muscle strength, and possibly get imaging of your feet to diagnose flat foot.

Treating Flat Foot

Treatment of flat feet depends on the cause and also the severity. However, your podiatrist is likely to recommend one or more of the following:

  • reducing tightness of calves by stretching
  • orthotics or more advanced devices if PTTD or Charcot foot are diagnosed to control the arch and prevent it from further collapse. For mild flatfoot over-the-counter arch supports may be sufficient, but most patients with more severe flatfoot will need correction of their foot mechanics with custom orthotics.
  • Cortisone injections, MLS laser if patient is experiencing pain from plantar fasciitis or Achilles tendonitis
  • Physical therapy
  • More supportive footwear
  • Weight loss

Need Relief from Flat Foot Pain in Seattle, Washington? Request an Appointment Now

Don't let foot pain cause you to miss out on the activities you enjoy. Complete the contact form on this page or call our office, the Foot and Ankle Center of Lake City, at 206-368-7000 to schedule an appointment with Dr. Rion Berg.

Most new patients are seen within 1-2 week's time. During your initial visit, Dr. Berg will spend up to 30 minutes getting to know you, your podiatry complaints, and your goals so that he can recommend the treatment best meets your needs. Don’t wait—contact us today.

North Seattle Foot & Ankle Specialist Dr. Rion Berg offers compassionate podiatry care for all foot and ankle problems to those living in Seattle Washington and the surrounding areas. Call us today at 206-368-7000 for an immediate appointment or request an appointment online.

Dr. Rion Berg
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A podiatrist in North Seattle treating families for over 40 years.