Flat Feet: Causes and Prevention

A flat foot is a medical condition that occurs when the bottoms of the feet are flat and without the typical arch. The bottom of the foot appears flat, the entire sole makes contact with the floor, and the feet often point outward.

Flat feet are common at birth as babies are born without arches and do not develop them until they are between the ages of two and six. At that time, the tendons and ligaments in the feet and leg tighten to form the arch. Some children may not develop the arches, with flat feet lasting throughout their lives. Supportive shoes are crucial.

Fallen arches occur later in life when the arches collapse and result in flat feet. A person can also have only one flat foot or both. Flat feet are not a significant problem for many people, although some may experience pain or difficulty walking.

According to a 2017 study, approximately 26 percent of people had flat feet, with older, overweight individuals having a greater predisposition to the condition. A higher comorbidity index and greater foot size increased the risk of developing flat feet.

Types and Symptoms of Flat Feet

Flat feet begin at birth and can persist into adulthood. Depending on the type of flat feet, they can also occur at any time in life. Most people do not experience any symptoms with flat feet, yet some do. The type and symptoms can impact one or both feet. Flat feet can lead to further problems, including hip, low back, and knee pains, because they change the legs’ alignment.

The most common types of flat feet include:

  • Adult-acquired: fallen arches occur when the arch drops or collapses and may be caused by torn leg tendons or inflammation.
  • Flexible: in this scenario, the arches are present when sitting or lying down yet disappear upon standing and putting weight on the feet. Most people who develop flexible flatfoot do so during childhood or teen years, and it worsens with age. Flexing the feet up, down, or sideways may be challenging.
  • Rigid: another form of flat feet that often develops in the teen years; there is no arch when sitting or standing. Flexing is difficult in any direction because the foot is stiff, and the problem and pain may worsen with age.
  • Vertical talus: a congenital defect that occurs when the talus bone is positioned wrong in the ankle and prevents the formation of arches. The bottom of the foot gives the impression of a rocking chair.

The most common symptoms of flat feet include:

  • Bunions
  • Changes in gait (walking)
  • Foot cramps
  • Hammertoes
  • Leg cramps
  • Muscle aches in the legs or feet
  • Muscle fatigue in the legs or feet
  • Pain in the ankle, arch, heel, or outer foot
  • Pain while walking or running
  • Shin splints
  • Swelling around the inside of the ankle
  • Tight Achilles tendon
  • Toe drift (pointing outward)

 Causes of Flat Feet

Tightening of tendons to form the arch occurs during early childhood. If the tightening does not occur or the bones become fused (such as in tarsal coalition), it can result in flat feet.

  • Injuries and breaks

Injuries to the feet or tendons can cause the arch to collapse. One such concern is Lisfranc injury, which can cause a painful flattening due to broken bones or torn ligaments in the midfoot. Increased severity of injuries can lead to arthritis in the foot.

  • Posterior tibial tendon dysfunction

One of the most common causes of flat foot is PTTD, a condition that occurs when the tendon running down the inside of the lower leg becomes torn, injured, or overused and swollen, resulting in arch collapse. Sports injuries can increase the risk of collapsed arches and flattened feet.

  • Cerebral palsy and muscular dystrophy

These conditions are associated with flat feet due to problems with muscles, tendons, ligaments, and bones.

  • Family history

Flat feet can run in families, making it more likely to develop the condition when present in other family members.

  • Diabetes

Nerve damage is often associated with diabetes and can cause flat feet, as neuropathy (loss of feeling) can reduce awareness of the changes in the feet. Charcot foot is a diabetes-related condition that can lead to flat feet. People with diabetes are at risk for severe collapse in the arch, which can include bone breakage and disintegration that can lead to deformation of the foot.

  • Down syndrome

People with Down syndrome have a higher risk of foot deformity issues, including having flat and wider feet and developing hallux valgus (a big toe bunion) that can progress into deformities in the remaining toes.

  • High blood pressure

Hypertension can lead to posterior tibial tendon dysfunction, a risk factor for flat feet. Plaque buildup in blood vessels associated with high blood pressure can decrease circulation in the feet and legs and increase the risk of peripheral artery disease (PAD). Reduced blood supply to the feet weakens the muscles and ligaments supporting the arches.

  • Aging

Children may have flexible flat feet that improve as their tendons strengthen and develop the arch. Wear and tear on the feet can happen gradually over the years, resulting in rigid flat feet associated with natural wear and tear.

  • Obesity

Excess weight increases pressure on the feet and tendons, which can cause the arch to collapse. Obesity is a common consequence of hormonal imbalance, such as HGH deficiency. HGH deficiency also can lead to reduced bone density, low energy levels, and fatigue. Learn about treatment options and how to buy Sermorelin online quickly and legally.

  • Pregnancy

Changing hormone levels during pregnancy can soften connective tissue, such as ligaments and tendons. Along with increased weight, that can lead to flattened arches. Flat feet associated with pregnancy may resolve after birth or may remain permanently.

  • Rheumatoid arthritis

Arthritis can attack and inflame the joints and cartilage in the foot, causing the arch to flatten.

Prevention Options

When flat feet are hereditary, they cannot be prevented. Avoiding injury to the feet can help reduce the risk in other cases.

There are not many options you can do to prevent flat feet. But to minimize the chances of developing flat feet, you can take some precautions, including:

  • Maintain a healthy weight

Carrying excess weight puts added pressure on the muscles, bones, and ligaments of the feet. Losing weight can help reduce that pressure.

  • Orthopedic arch supporting shoe insert

Arch supports, especially those prescribed by a doctor, can help reduce flat feet symptoms. Custom-made orthotics provide the best stability.

  • Avoid wearing high heels and tight shoes

Wearing shoes that provide the feet with excellent support can help reduce flat feet risk and foot pain.

  • Stretching and strengthening exercises

Exercises that you can do at home include arch lifts, calf raises, golf ball rolls, and heel stretches. These exercises help strengthen and lengthen the tendons and muscles in the feet. Yoga and Pilates exercises can also help strengthen the muscles and tendons for added support.

  • Eat a balanced diet

Proper dietary habits, such as lean protein, fresh fruit and vegetables, and whole grains, can help control weight, diabetes, and hypertension.

  • Manage high blood pressure and diabetes

Because these conditions increase the risk of developing flat feet, keeping them under control can help reduce the risk.


Contacting a podiatrist or orthopedic foot and ankle specialist can help determine the cause of flat feet and provide the appropriate treatment. Along with orthotics, physical therapy may help in some instances.

If you have certain risk factors for flat feet, controlling health problems can reduce those concerns. Losing weight, wearing supportive shoes, and surgery when necessary to repair torn tendons or broken bones may offer some relief.

Flat feet can cause problems with balance in some individuals, increasing the risk of falls and fractures. Getting help sooner can reduce those risks. Over-the-counter pain medications can help reduce pain and inflammation.

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