How to Treat Flatfeet and Fallen Arches

Portrait of Young Woman's Feet Relaxing in Field
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Walking or running "flat-footed" is a walking mistake that can be corrected, while having flat feet or fallen arches are conditions that may cause you pain. They sound similar but have different solutions.

When Flat Feet Are a Problem

Do you have fallen arches or flatfoot that cause you enough pain that you avoid walking and exercise? The American College of Foot and Ankle Surgeons (ACFAS) estimates that 5 percent of adults have this problem. They published clinical practice guidelines in 2005 to assist physicians in treating flatfoot when it is painful and limits your healthy lifestyle. "For many adults, flat feet cause nagging foot pain that gets worse over time. It's tough to be active, shed excess pounds and maintain a healthy lifestyle if your feet hurt constantly," said Kris DiNucci, DPM, FACFAS, in a press release.

A study in 2011 found that older adults with flat feet had 1.3 times the risk of knee pain and 1.4 times the risk of knee cartilage damage than those who did not.

Flexible Flatfoot

If your foot is flat when you are standing but it rebounds to a normal arch height when you sit, this is known as flexible flatfoot. When it is painful and medical treatment is sought, the ACFAS guideline recommends first using non-invasive treatments including changing or limiting activity and doing stretching exercises. Stretching the Achilles tendon, which attaches to the calf muscle, can be helpful in treating pain related to flatfoot. Your physician may prescribe non-steroidal anti-inflammatory medication or custom shoe orthotics.  In some cases, if you still have pain after trying those treatments, surgery may be an option.

Shoes for Flatfoot Walkers

People with flatfoot often overpronate and one solution is wearing motion control shoes that limit the excessive side-to-side roll of the ankle during walking or running. Not everyone with flat feet overpronates, so it is something you may need to have checked in order to get the right shoes. A running shoe expert can often help assess your gait. If you are prescribed orthotics, you will want to look for shoes that have a removable insole and enough volume so you can comfortably wear it in your walking shoes.

Adult-Acquired Flatfoot Deformity

Adult-acquired flatfoot is a more serious condition that can be related to many causes, leading to a rigid flat foot. While the arch rebounds in flexible flatfoot, in this condition it stays flat even when you aren't standing on it. You may lose your range of motion in the foot and ankle and have pain in your arch. The ACFAS clinical guideline recommends that flatfoot can be treated with custom shoe orthotics, soft casts, walking boots, physical therapy, and non-steroidal anti-inflammatory medications. If there is no relief or the condition worsens, then the patient may be referred to surgery.

Walking Flat-Footed

People with normal arches or flat feet can find themselves walking flat-footed. In this case, the feet slap down with each step from the ankle rather than striking with the heel and rolling through a step, pushing off with the toe. Instead, their heel hits the ground and flattens out with a slap. Or, they land flat-footed already at mid-sole with no heel strike.

Flat-footed walking may be caused by having shoes that are too stiff. Flexible shoes that bend at the ball of the foot may be helpful in these cases.

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  1. Lee MS, Vanore JV, Thomas JL, et al. Diagnosis and treatment of adult flatfoot. J Foot Ankle Surg. 2005;44(2):78-113. doi:10.1053/j.jfas.2004.12.001.

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