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

Risk Factors

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

Types of Flatfoot

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:

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 Footphoto of 3 foot types

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. In addition, you can do your own test at home by wetting the bottom of your foot, stepping on a piece of paper and then comparing it to the image on the right.

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 or PRP (Platelet-Rich Plasma) if patient is experiencing pain from plantar fasciitis or Achilles tendonitis
  • Physical therapy
  • More supportive footwear
  • Weight loss

Give our office a call at 206-368-7000 to learn more about how to relieve the pain caused by flat feet.