Understanding Flat Feet (Pes Planus)

Your Questions Answered Expert Insights from Our Orthopaedic Foot & Ankle Surgeon

What Are Flat Feet?

Flat feet, or pes planus, occur when the arch on the inner side of the foot is lower than normal or absent. When standing, the entire sole may touch the ground. Flat feet are common in both children and adults. Many people experience no symptoms, while others develop pain or progressive deformity that affects walking, daily activities, and overall quality of life.

Are Flat Feet Always a Problem?

Not necessarily.

Flat feet require attention only if they cause symptoms such as:

Pain along the inner side of the foot or ankle
Swelling around the ankle
Fatigue with prolonged standing or walking
Progressive flattening of the foot

Persistent pain is not normal and should not be ignored.

What Causes Flat Feet in Adults?

The most common cause is weakening of the posterior tibial tendon, which supports the arch

Other risk factors include

Age-related tendon degeneration
Previous injury
Inflammatory arthritis
An accessory navicular (an extra small bone on the inner side of the foot present from birth)

An accessory navicular can interfere with tendon function and contribute to arch collapse when irritated. As the tendon weakens, the arch gradually flattens — a condition known as adult acquired flatfoot deformity. Early treatment can prevent progression.

What About Flat Feet in Children?

Flat feet are common in children and often part of normal development. The arch usually forms as they grow. Treatment is necessary only if there is pain, stiffness, or worsening deformity of the foot or ankle.

How Are Flat Feet Diagnosed?

Diagnosis begins with a detailed clinical examination. This includes assessment of:

Foot alignment while standing
Flexibility of the arch
Tendon strength
Walking pattern

X-rays are typically performed to evaluate bone alignment. MRI scans may be required if tendon damage is suspected.

Treatment Options

Treatment depends on symptom severity and stage of deformity.

Non-Surgical Treatment

Supportive footwear
Custom orthotic insoles
Physiotherapy
Activity modification

Many patients improve significantly with early non-surgical care.

Surgical Treatment

Surgery is considered when pain persists despite conservative management or when the deformity progresses.

Flatfoot surgery corrects bone alignment and repairs or reconstructs damaged tendons, restoring stability and function while preventing long-term complications.

When Should You See an Orthopaedic Foot and Ankle Specialist?

Consult an orthopaedic foot and ankle specialist if you experience:

Persistent foot or ankle pain
Swelling along the inner ankle
Progressive flattening of the foot

Early evaluation allows for simpler treatment and better long-term outcomes.

When to Take Action

Flat feet are common — but ongoing pain is not.

If you notice persistent discomfort, swelling, or progressive flattening of your arch, don’t wait. Early evaluation by an orthopaedic foot and ankle specialist can clarify whether treatment is needed and prevent more serious problems later. Taking action early helps you stay active, mobile, and pain-free, giving you confidence and comfort in every step.