You have flatfeet when the arch on the inside of your feet is flattened, allowing the entire sole

of your foot to
touch the floor when you stand up.
A common and usually painless condition, flatfeet may occur when the arches don't develop during childhood.
In other cases, flatfeet may develop after an injury or from the simple wear-and-tear stresses of age.
Flatfeet can sometimes contribute to problems in your ankles and knees because the condition can alter
optimal alignment of your legs. If you aren't experiencing any pain, no treatment is usually necessary for
flatfeet.

Flat feet
From Wikipedia, the free encyclopedia

"Flatfoot" redirects here. For the band Flatfoot 56, see Flatfoot 56. For Film starring Bud Spencer,
see Piedone lo sbirro.

Flat feet

Classification and external resources

A flat foot.

ICD-10

M21.4, Q66.5

ICD-9

734

DiseasesDB

4852

MedlinePlus

001262

MeSH

D005413

Flat feet (also called pes planus or fallen arches) is a postural deformity in which the arch of the
foot collapses, with the entiresole of the foot coming into complete or near-complete contact with the
ground. In some individuals (an estimated 2030% of the general population) the arch simply never
develops in one foot (unilaterally) or both feet (bilaterally).
There is a functional relationship between the structure of the arch of the foot and the biomechanics
of the lower leg. The arch provides an elastic, springy connection between the forefoot and the hind
foot. This association safeguards that a majority of the forces incurred during weight bearing of the
foot can be dissipated before the force reaches the long bones of the leg and thigh.[1]
In pes planus, the head of the talus bone is displaced medially and distal from the navicular. As a
result, the spring ligament and the tendon of the tibialis posterior muscle are stretched, so much so
that the individual with pes planus loses the function of the medial longitudinal arch (MLA). If the
MLA is absent or nonfunctional in both the seated and standing positions, the individuals has rigid
flatfoot. If the MLA is present and function while the individual is sitting or standing up on their toes,
but this arch disappear when a foot-flat stance, the individual has supple flatfoot. This latter
condition can be correctable with well-fitting arch supports.[1]
Three studies (see citations below in military section) of military recruits have shown no evidence of
later increased injury, or foot problems, due to flat feet, in a population of people who reach military
service age without prior foot problems. However, these studies cannot be used to judge possible
future damage from this condition when diagnosed at younger ages. They also cannot be applied to
persons whose flat feet are associated with foot symptoms, or certain symptoms in other parts of the
body (such as the leg or back) possibly referable to the foot.
Contents
[hide]

1 Flat feet in children

o 1.1 Treatment
2 Flat feet in adults
o 2.1 Pathophysiology
o 2.2 Diagnosis
o 2.3 Treatment
3 Running
4 Military studies
5 See also
6 References

Flat feet in children[edit]

foot with a typical arch

Flat feet of a child are usually expected to develop into high or proper arches, as shown by feet of the mother.

The appearance of flat feet is normal and common in infants, partly due to "baby fat" which masks
the developing arch and partly because the arch has not yet fully developed. The human arch
develops in infancy and early childhood as part of normal muscle, tendon, ligament andbone growth.
Training of the feet, especially by foot gymnastics and going barefoot on varying terrain, can
facilitate the formation of arches during childhood, with a developed arch occurring for most by the
age of four to six years. Flat arches in children usually become proper arches and high arches while
the child progresses through adolescence and into adulthood.
Because young children are unlikely to suspect or identify flat feet on their own, it is a good idea for
parents or other adult caregivers to check on this themselves. Besides visual inspection, parents
should notice whether a child begins to walk oddly or clumsily, for example on the outer edges of the
feet, or to limp, during long walks, and to ask the child whether he or she feels foot pain or fatigue
during such walks. Children who complain about calf muscle pains or any other pains around the
foot area may be developing or have flat feet. Pain or discomfort may also develop in the knee joints.
A recent randomized controlled trial found no evidence for the efficacy of treatment of flat feet in
children either for expensive prescribed orthoses (shoe inserts) or less expensive over-the-counter
orthoses.[2]

Treatment[edit]
Going barefoot, particularly over terrain such as a beach where muscles are given a good workout,
is good for all but the most extremely flatfooted, or those with certain related conditions such
as plantar fasciitis. Ligament laxity is also among the factors known to be associated with flat feet.
One medical study in India with a large sample size of children who had grown up wearing shoes
and others going barefoot found that the longitudinal arches of the bare footers were generally
strongest and highest as a group, and that flat feet were less common in children who had grown up
wearing sandals or slippers than among those who had worn closed-toe shoes. Focusing on the
influence of footwear on the prevalence of pes planus, the cross-sectional study performed on
children noted that wearing shoes throughout early childhood can be detrimental to the development
of a normal or a high medial longitudinal arch. The vulnerability for flat foot among shoe-wearing
children increases if the child has an associated ligament laxity condition. The results of the study
suggest that children be encouraged to play barefooted on various surfaces of terrain and that
slippers and sandals are less harmful compared to closed-toe shoes. It appeared that closed-toe
shoes greatly inhibited the development of the arch of the foot more so than slippers or sandals. This
conclusion may be a result of the notion that intrinsic muscle activity of the arch is required to
prevent slippers and sandals from falling off the childs foot.[3]

Flat feet in adults[edit]

Flat feet can also develop as an adult ("adult acquired flatfoot") due to injury, illness, unusual or
prolonged stress to the foot, faulty biomechanics,[4] or as part of the normal aging process. This is
most common in women over 40 years of age. Known risk factors include
obesity, hypertension and diabetes.[5] Flat feet can also occur in pregnant women as a result of
temporary changes, due to increased elastin (elasticity) during pregnancy. However, if developed by
adulthood, flat feet generally remain flat permanently.

Flatfoot in a 55 year-old female with ankle and knee arthritis.

If a youth or adult appears flatfooted while standing in a full weight bearing position, but an arch
appears when the person dorsiflexes (stands on heel or pulls the toes back with the rest of the foot
flat on the floor), this condition is called flexible flatfoot. This is not a true collapsed arch, as
the medial longitudinal arch is still present and the Windlass mechanism still operates; this
presentation is actually due to excessive pronation of the foot (rolling inwards), although the term 'flat
foot' is still applicable as it is a somewhat generic term. Muscular training of the feet, while generally
helpful, will usually not result in increased arch height in adults, because the muscles in the human
foot are so short that exercise will generally not make much difference, regardless of the variety or
amount of exercise.[citation needed] However, as long as the foot is still growing, it may be possible that a
lasting arch can be created.

Pathophysiology[edit]
Research has shown that tendon specimens from people who suffer from adult acquired flat feet
show evidence of increased activity ofproteolytic enzymes. These enzymes can break down the
constituents of the involved tendons and cause the foot arch to fall. In the future, these enzymes
may become targets for new drug therapies.[5]

Diagnosis[edit]
Many medical professionals can diagnose a flat foot by examining the patient standing or just
looking at them. On going up onto tip toe the deformity will correct when this is a flexible flat foot in a
child with lax joints. Such correction is not seen in the adult with a rigid flat foot.
An easy and traditional home diagnosis is the "wet footprint" test, performed by wetting the feet in
water and then standing on a smooth, level surface such as smooth concrete or thin cardboard or
heavy paper. Usually, the more the sole of the foot that makes contact (leaves a footprint), the flatter
the foot. In more extreme cases, known as a kinked flatfoot, the entire inner edge of the footprint
may actually bulge outward, where in a normal to high arch this part of the sole of the foot does not
make contact with the ground at all.

Treatment[edit]
Most flexible flat feet are asymptomatic, and do not cause pain. In these cases, there is usually no
cause for concern, and the condition may be considered a normal human variant. Flat feet were
formerly a physical-health reason for service-rejection in many militaries. However, three military
studies on asymptomatic adults (see section below), suggest that persons with asymptomatic flat
feet are at least as tolerant of foot stress as the population with various grades of arch.
Asymptomatic flat feet are no longer a service disqualification in the U.S. military.[citation needed]
In a study performed to analyze the activation of the tibialis posterior muscle in adults with pes
planus, it was noted that the tendon of this muscle may be dysfunctional and lead to disabling
weightbearing symptoms associated with acquired flat foot deformity. The results of the study
indicated that while barefoot, subjects activated additional lower-leg muscles to complete an
exercise that resisted foot adduction. However, when the same subjects performed the exercise

while wearing arch supporting orthotics and shoes, the tibialis posterior was selectively activated.
Such discoveries suggest that the use of shoes with properly fitting, arch-supporting orthics will
enhance selective activation of the tibialis posterior muscle thus, acting as an adequate treatment for
the undesirable symptoms of pes planus.[6]
Rigid flatfoot, a condition where the sole of the foot is rigidly flat even when a person is not standing,
often indicates a significant problem in the bones of the affected feet, and can cause pain in about a
quarter of those affected.[7][8] Other flatfoot-related conditions, such as various forms
of tarsal coalition (two or more bones in the midfoot or hindfoot abnormally joined) or an
accessory navicular (extra bone on the inner side of the foot) should be treated promptly, usually by
the very early teen years, before a child's bone structure firms up permanently as a young adult.
Both tarsal coalition and an accessory navicular can be confirmed by x-ray. Rheumatoid Arthritis can
destroy tendons in the foot (or both feet) which can cause this condition, and untreated can result in
deformity and early onset of Osteoarthritis of the joint.[citation needed] Such a condition can cause severe
pain and considerably reduced ability to walk, even with orthoses. Ankle fusion is usually
recommended.[citation needed]
Treatment of flat feet may also be appropriate if there is associated foot or lower leg pain, or if the
condition affects the knees or the lower back. Treatment may include usingOrthoses such as an arch
support, foot gymnastics or other exercises as recommended by a podiatrist/orthotist or physical
therapist. In cases of severe flat feet, orthoses should be used through a gradual process to lessen
discomfort. Over several weeks, slightly more material is added to the orthosis to raise the arch.
These small changes allow the foot structure to adjust gradually, as well as giving the patient time to
acclimatise to the sensation of wearing orthoses. Once prescribed, orthoses are generally worn for
the rest of the patient's life. In some cases, surgery can provide lasting relief, and even create an
arch where none existed before; it should be considered a last resort, as it is usually very time
consuming and costly.[citation needed]

Running[edit]
It is generally accepted by professionals that a person with flat feet tends to overpronate in his or her
running form.[9] However, persons with flat feet may also have a neutral or underpronating gait.
Pronation is a natural form of shock absorption during running and walking, when the ankle rolls
inward and the weight distribution in the foot shifts medially. Overpronation is excessive pronation; it
disrupts the alignment of the leg and may result in injuries due to over-stressing of the knee and leg.
With normal, or neutral, running shoes, a person who overpronates in his or her running form may
be more susceptible to shin splints, back problems, and tendonitis in the knee.[10] Running in shoes
with extra medial support or using special shoe inserts, orthoses, may help correct one's running
form by reducing pronation and may reduce risk of injury.[11]

Military studies[edit]
Studies analyzing the correlation between flat feet and physical injury in soldiers have been
inconclusive, but none suggests that flat feet are an impediment, at least in soldiers who reached the
age of military recruitment without prior foot problems. Instead, in this population, there is a
suggestion of more injury in high arched feet. A 2005 study of Royal Australian Air Force recruits
that tracked the recruits over the course of their basic training found that neither flat feet nor high
arched feet had any impact on physical functioning, injury rates or foot health. If anything, there was
a tendency for those with flat feet to have fewer injuries.[12] Another study of 295 Israel Defense
Forces recruits found that those with high arches suffered almost four times as many stress fractures
as those with the lowest arches.[13] A later study of 449 U.S. Navy special warfare trainees found no
significant difference in the incidence of stress fractures among sailors and Marines with different
arch heights.[14]

See also[edit]

Arches of the foot

Marfan syndrome
Ehlers-Danlos syndrome

References[edit]
1.
2.

3.
4.
5.
6.
7.

8.
9.
10.
11.
12.
13.
14.

^ Jump up to:a b Franco, Abby Herzog (1987). "Pes Cavus and Pes Planus Analyses and Treatment.". Physical
Therapy 67 (5): 688694.
Jump up^ Whitford D., Esterman A. (2007). "A randomized controlled trial of two types of in-shoe orthoses in children
with flexible excess pronation of the feet". Foot and Ankle International (University of South Australia, Spencer Gulf Rural
Health School) 28 (6): p. 71523. doi:10.3113/FAI.2007.0715. PMID 17592702.
Jump up^ Rao UB, Joseph B (1992). "The influence of footwear on the prevalence of flat foot. A survey of 2300
children". J Bone Joint Surg Br 74 (4): 5257. PMID 1624509.quoted in http://www.unshod.org/pfbc/pfmedresearch.htm
Jump up^ http://www.eatmoveimprove.com/2009/11/shoes-sitting-and-lower-body-dysfunctions/[unreliable medical source?]
^ Jump up to:a b "Advance toward treatment for painful flat feet". ScienceDaily. 2012-01-11.
Jump up^ Kulig, Kornelia; et al. (2005). "Effect of foot orthoses on tibialis posterior activation in persons with pes
planus.". Med Sci Sports Exerc 37 (1): 2429.doi:10.1249/01.mss.0000150073.30017.46.
Jump up^ "Fallen Arch". Health A to Z. Aetna InteliHealth(R). 2007-12-18. Retrieved 2008-05-27. "Unlike a flexible
flatfoot, a rigid flatfoot is often the result of a significant problem affecting the structure or alignment of the bones that
make up the foot's arch."
Jump up^ "Flatfoot". Orthopedics: Conditions Treated. Children's Hospital and Regional Medical Center. Retrieved
2008-05-27. "About one in four people with rigid flatfoot has pain and disability."
Jump up^ "Pronation, Explained." Runner's World Aug 2004.
Jump up^ Mata. "Best Running Shoes for Your Feet" (www.thebestrunningshoestoday.com/choose-best-running-shoesflat-feet/).
Jump up^ Hintermann, Beat, and Benno Niggs. "Pronation in Runners: Implications for Injuries." Sports Medicine 26.3
(1998)
Jump up^ Esterman A, Pilotto L. (July 2005). "Foot shape and its effect on functioning in Royal Australian Air Force
recruits. Part 1: Prospective cohort study". Military Medicine 170 (6): p. 6238. PMID 16130646.
Jump up^ Giladi M, Milgrom C, Stein M, et al. The low arch, a protective factor in stress fractures: a prospective study of
295 military recruits. Orthop Rev 1985;14:824.
Jump up^ Jones, Bruce H.; Thacker, Stephen B.; Gilchrist, Julie; Kimsey, Jr., C. Dexter; Sosin, Daniel
(2002). "Prevention of Lower Extremity Stress Fractures in Athletes and Soldiers: A Systematic Review". Epidemiologic
Reviews 24 (2): 228247.doi:10.1093/epirev/mxf011. PMID 12762095.

Flat Feet
Flat feet are a common condition. In infants and toddlers, the
longitudinal arch is not developed and flat feet are normal. Most
feet are flexible and an arch appears when the person stands on
his or her toes. The arch develops in childhood, and by adulthood
most people have developed normal arches.
Most flat feet usually do not cause pain or other problems. Flat
feet may be associated with pronation, a leaning inward of the

ankle bones toward the center line. Shoes of children who

pronate, when placed side by side, will lean toward each other
(after they have been worn long enough for the foot position to
remodel their shape).
Foot pain, ankle pain or lower leg pain, especially in children, may
be a result of flat feet and should be evaluated.
Painful progressive flatfoot, otherwise known as Tibialis Posterior
Tendonitis, is caused by inflammation of the tendon of the tibialis
posterior. The tendon then becomes inflamed, stretched or
suffers a partial or total tear. If left untreated, this condition may
lead to severe disability and chronic pain. Some people are
predisposed to this condition if they have flatfeet or an abnormal
attachment of the tendon to the bones in the midfoot.
In some cases, a surgical operation may need to be performed to
repair the torn or damaged tendon and restore normal function.
To prevent reinjury, special orthotic devices may be
recommended. In severe cases, surgery on the midfoot bones
may be necessary to treat the associated flatfoot condition.

Metatarsalgia
Foot pain in the "ball of your foot," the area between your arch
and the toes, is generally called metatarsalgia. The pain usually
centers on one or more of the five bones (metatarsals) in this
mid-portion of the foot.
Also known as "dropped metatarsal heads," metatarsalgia can
cause abnormal weight distribution due to over-pronation.
Metatarsalgia causes one of metatarsal joints to become painful
or inflamed. People often develop a callus under the affected
joint. Metatarsalgia can also be caused by arthritis, foot injury
(sports, car accidents, repeated stress), hard surfaces (cement or

tile floors) and specific footwear (rigid soled work boots).

Inappropriate shoes will only aggravate the condition.

Plantar Fibromas
A plantar fibroma is a benign tissue tumor or growth on the
plantar, or bottom surface of the foot. Unlike plantar warts, which
grow on the skin, these grow deep inside on a thick fibrous band
called the plantar fascia. Non-surgical measures for treating
plantar fibromas, such as orthotics, have failed to provide
adequate relief of symptoms. Surgical correction can lead to
further complications such as plantar nerve entrapment and
larger and recurrent fibromas often worse than the original
problem. The CRYOSTAR Cryoanalgesia procedure has been
shown to shrink these fibromas with the use of extreme cold
technology. The fibromas treated to date have decreased in size,
become softer, and much less painful. This 7 minute treatment
causes minimal to no
How do you get flat feet
If you have any additional questions on how do you get flat feet or preventative measures
you can take please give us a call. We look forward to helping you today.

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The podiatrists at Foot HealthCare Associates treat all foot and ankle problems such as: advanced
endoscopic gastrocnemius recession surgery, bunions, diabetic foot care, heel pain, ingrown toenails,
shockwave therapy for plantar fasciitis, sports medicine therapy, surgical and non-surgical flatfoot
treatments, and tri-correctional bunion surgery; in Livonia & Southfield, MI. How do you get flat feet,
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post operative disability and patients can return to regular shoe

gear with 24-48 hours after cryosurgery.

Sesamoiditis
There are a few bones in the human body that are connected only
to tendons or are embedded in muscle. These are the sesamoids.
Two very small sesamoids (about the size of a kernel of corn) are
found in the underside of the forefoot near the great toe - one on
the outer side of the foot and the other closer to the middle of the
foot.
Sesamoids provide a smooth surface over which the tendons
slide, thus increasing the ability of the tendons to transmit
muscle forces. The sesamoids in the forefoot also assist with
weight-bearing and help elevate the bones of the great toe. Like
other bones, sesamoids can fracture. Additionally, the tendons
surrounding the sesamoids can become irritated or inflamed. This
is called sesamoiditis and is a form of tendonitis, and is common
among ballet dancers, runners and baseball catchers.
Symptoms include:
*Pain under the big toe or on the ball of the foot.
*Swelling and bruising.
*Difficulty and pain in bending and straightening the big toe.

Why are people with flat feet not allowed to join the army? Or is it just a myth?
Saul Cohen, London UK

At least in the US and Canadian armies, the answer depends upon the definition
of "flat feet". Most feet that could be labeled "flat" are not an impediment but a

small proportion (3% of all examined in one study) were so malformed as to

disqualify. It may be that discharge for flat feet that is so commonly claimed is
actually for other, less socially acceptable reasons.
David Dreaming Bear, Horsethief Canyon, California USA

Those with flat feet are not suited to marching - they can sustain spinal damage.
The government may not care if one is killed, but cannot take the chance of
anyone's seeking a disability pension.
Elizabeth M, New York City US

Marching requires a heel to toe foot movement that cannot easily be achieved by
someone sporting feet akin to Donald Duck!
Darius Hurley, Chicago U

What Are Flat Feet and Why Do I Have Them?

Dreah Lauraine, Yahoo Contributor Network
Sep 16, 2009

MORE:
Flat Feet
Fallen Arches
Causes of Dry Feet
Arches
Orthotics
FlagPost a comment

Flat feet, a condition also called fallen arches, is when a person literally has flat feet. Most people's feet have a curve or an
arch at the bottom that provides flexibility and shock absorption. A person with flat feet is at a disadvantage and will have
more pain and stress on the feet and legs.
You can tell you have flat feet by observing the feet and looking for the presence of an arch. This is most visible below the
inside ankle. If you have little to know arch, then your feet are flat. Other indications of flat feet are when you wear your
shoes down quickly on the insides causing the to lean toward each other. A person with flat feet will also have pain and
swelling amount the ankles and feet. Back pain can also be a symptom of having flat feet.
Most people are born with flat feet but as the child ages, the network of twenty six bones, one hundred muscles, and thirty
three joints form into an arch that works as springs for the feet to absorb weight and force as we walk. Usually due to

hereditary, some people never form arches in their feet. Other lose their arches due to tearing of the posterior tibial tendon,
traumatic foot injury, diabetes, pregnancy, arthritis, or aging.
People with flat feet can live relatively normal lives. You hear stories of people not getting into the army because of flat feet
which may have been the case at one time, but now you are only prevented from joining if your flat feet cause pain. Most
people get used to the discomfort and learn to deal with it. Having flat feet can cause daily problems such as inflammation,
tendinitis, arthritis, and shin splints. Hammertoes and bunions are common in people with flat feet as is poor balance due to
rolling feet inward while walking.
Flat feet cannot be cured in most cases, though surgery can repair a torn ligament in some cases. Most people with flat feet
need to take steps to manage the discomfort. This is done with the help of arch orthotics to add cushioned arch to the shoes.
Ankle and leg braces can help in severe cases and sometimes it is recommended that the person lose weight to reduce the
amount of stress on the feet.
For a person who has arched feet but the arches are falling as evidenced through pain and visible lowering of the foot, you
can take preventative measures. See a podiatrist who can prescribe arch support and have them diagnose any possible
trauma that can be reversed through surgery.

A person with flat feet (fallen arches) has low arches or no

arches at all.
Most cases don't cause problems and treatment isn't usually
needed.
The arch, or instep, is the inside part of the foot that's usually raised
off the ground when you stand, while the rest of the foot remains flat
on the ground.
Most people have a noticeable space on the inner part of their foot
(the arch). The height of the arch varies from person to person.

Do I have flat feet?

Flat feet are easy to identify while standing or walking. When
someone with flat feet stands, their inner foot or arch flattens and
their foot may roll over to the inner side. This is known as
overpronation.

To see whether your foot overpronates, stand on tiptoes or push

your big toe back as far as possible. If the arch of your foot doesn't
appear, your foot is likely to overpronate when you walk or run.
It can be difficult to tell whether a child has flat feet because their
arches may not fully develop until they're 10 years of age.

Causes of flat feet

Having low or no arches is normal for some people. In these cases,
flat feet are usually inherited and the feet are fairly flexible.
Occasionally, flat feet can be caused by an abnormality that
develops in the womb, such as a problem with a joint or where two
or more bones are fused together. This is known as tarsal coalition
and results in the feet being flat and stiff.
Flat feet that develop in later life can be caused by a condition that
affects the joints, such as arthritis, or an injury to a muscle, tendon
or joint in the foot.
Conditions that affect the nervous system (brain and spinal cord)
can also cause the arches to fall. Over time, the muscles gradually
become stiffer and weaker and lose their flexibility. Conditions
where this can occur include cerebral palsy, spina
bifida and muscular dystrophy.
Adult-acquired flat feet often affect women over 40 years of age. It
often goes undiagnosed and develops when the tendon that
supports the foot arch gradually stretches over time.
It's not fully understood what causes the tendon to become
stretched, but some experts believe that wearing high heels and
standing or walking for long periods may play a part.Obesity, high
blood pressure (hypertension) and diabetesare all risk factors.
Recent research has found a link with changes to the tendon in the
foot and an increase in a type of protein called proteolytic enzyme.
These enzymes can break down some areas of the tendon,
weakening it and causing the foot arch to fall. Similar changes are
also seen in other conditions, such as Achilles tendonitis.
This could have important implications for treating flat feet because
medication that specifically targets these enzymes could provide an

alternative to surgery. However, further research is needed and this

type of treatment is thought to be about 10 to 15 years away.

Problems caused by flat feet

Flat feet don't usually cause problems, but they can put a strain on
your muscles and ligaments (ligaments link two bones together at a
joint). This may cause pain in your legs when you walk.
If you have flat feet, you may experience pain in any of the following
areas:

the inside of your ankle

the arch of your foot

the outer side of your foot

the calf

the knee, hip or back

Some people with flat feet find that their weight is distributed
unevenly, particularly if their foot rolls inwards too much
(overpronates). If your foot overpronates, your shoes are likely to
wear out quickly. Overpronation can also damage your ankle joint
and Achilles tendon (the large tendon at the back of your ankle).
When to see your GP
See your GP if you or your child has flat feet and your:

feet are painful, even when wearing supportive, well-fitting shoes

shoes wear out very quickly

feet appear to be getting flatter

feet are weak, numb or stiff

Your GP may refer you to a podiatrist (foot specialist).

Treating flat feet

Treatment isn't usually needed for flat feet because the condition
doesn't usually cause any significant problems.
Aching feet can often be relieved by wearing supportive shoes that
fit properly. You may need to wear shoes that are wider than
normal.

If your feet overpronate, you may need to wear a special insole (an
orthotic) inside your shoes to stop your feet rolling inwards when
you walk or run. These will usually need to be made and fitted by a
podiatrist.
Stretching your calf and Achilles tendon may also help as a tight
Achilles can make your foot overpronate. To stretch your calf and
Achilles tendon:

step forwards with your left leg and bend it, with your right leg straight and both feet pointing forwards (see
picture)

push your right heel into the ground while keeping your right leg straight; you should feel the stretch at the back
of your right leg, below the knee

hold the stretch for 15 to 30 seconds and repeat with the opposite leg

repeat the stretch two to four times on each leg, and repeat the overall exercise three to four times a day

When surgery may be needed

In rare cases, surgery may be needed if a child has flat feet caused
by a problem they're born with (a congenital abnormality). The foot
may need to be straightened or the bones may need to be
separated if they're fused together.
Painkillers and insoles are the first treatment options for flat feet that
are caused by a joint problem, such as arthritis or a torn tendon.
However, surgery may be recommended if the injury or condition is
severely affecting your feet.
Where flat feet are caused by a condition that affects the nervous
system, special shoes, insoles, or supportive foot or leg braces may
be needed. Again, in severe cases, an operation may be needed to
straighten the feet.