Trusted medical advice from the
American Academy of Family Physicians.

Flat Feet

What are flat feet?

Flat feet is a common condition in which one or both feet don’t have normal arches. At first, all babies’ feet look flat because an arch hasn’t formed yet. Arches should form by the time a child is 2 or 3 years of age. Flat feet, even in older children, usually do not cause any problems.

You may be born with flat feet or develop them over time. Adults may not realize they have flat feet for many years. They may not ever notice if they don’t have symptoms related to flat feet.

Symptoms of flat feet

If your child complains of foot or ankle pain, take them to the doctor. Flat feet in an older child may cause pain in the heel or arch. This condition also may cause pain when your child is walking and running.

Symptoms in adults of flat feet include tired or achy feet after long periods of standing. Feet may also ache following activity, like playing sports or exercising. Flat feet can also cause pain in your lower back, hips, and knees.

What causes flat feet?

In children, most flat feet are caused by loose joint connections and baby fat between the foot bones. These conditions make the arch fall when your child stands up. This is why you sometimes hear flat feet called “fallen arches.” The feet may look like they have arches when your child is sitting or when the big toe is bent backward. But the arch flattens when your child puts weight on the foot.

Rarely, flat feet can be caused by foot bones that are joined together.

In adults, a number of things can cause flat feet. Adult-acquired causes for flat feet include:

  • Weakened or torn tendons. Tendons offer support to your arches. If you tear a tendon or even weaken it over time, it can cause flat feet.
  • Rheumatoid arthritis. This type of arthritis can progressively cause deformities in your joints. These deformities can cause flat feet.
  • Broken bones. Damaging bones in your mid foot can cause flat feet.
  • Ligament injuries. Ligaments support your bones. An injury to these can impact your joints, which can cause flat feet.

How are flat feet diagnosed?

Your doctor will look at your child’s feet to make sure that the pain isn’t caused by a problem in the hip or the knee. Your child may need to have X-rays. Most often, your doctor probably can tell you what the problem is just by looking at your child’s feet.

If you have adult-acquired flat feet, your doctor should be able to diagnose it by examining your feet. They may ask you to stand and will observe your feet from various angles. Your doctor also may ask you to stand on your toes. Your doctor may also order tests, such as X-ray, MRI, or CT scan to diagnose your flat feet.

Can flat feet be prevented or avoided?

Adult flat feet can sometimes be prevented through good foot care. Taking care of your feet and avoiding injury are important. You may be at higher risk for developing flat feet if you have diabetes or are pregnant. You are also more likely to develop flat feet if you are overweight.

Flat feet treatment

For many people, flat feet don’t cause pain or related problems so there is usually no need to treat them. If flat feet are painful, there are several treatment options. Some of these include:

  • Stretching exercises
  • Physical therapy
  • Supportive shoes
  • Arch supports
  • Surgery

Your doctor can help you decide which treatment is best.

Your child’s foot development will be the same whether arch supports are worn or not. High-top or special orthopedic shoes, “cookies,” or wedges are only useful to keep the shoe on your child’s foot. If your child has foot pain because of flat feet, a heel cup, shoe insert, or shoes with support may help.

People with flat feet don’t need to limit activities. If flat feet become painful from overuse, your doctor may recommend you rest them. Wearing a certain style of shoe, walking barefoot, running, doing foot exercises, or jumping will not make flat feet better or worse.

If you or your child has pain from flat feet, some over-the-counter medicines may help, including ibuprofen (one brand name: Advil) and naproxen (one brand name: Aleve).

Living with flat feet

Flat feet are common. If flat feet cause you pain, talk to your doctor. Most of the time, this pain can be managed with rest. Supportive footwear can also help.

Questions to ask your doctor

  • What is the likely cause of my/my child’s foot pain?
  • What is the best treatment option for me/my child?
  • Is there anything I can do to help relieve my/my child’s pain?
  • Is it safe for me/my child to exercise? What kind of exercise should I/they do?
  • Will my/my child’s flat feet cause any long-term problems?
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