Flat Foot

Flat feet or fallen arches are one of the most common foot deformities, along with splayfoot. In particular, the longitudinal arch of the foot is greatly flattened, so that the foot as a whole is almost completely on the ground when walking. Flat feet are usually congenital, but can also occur as a result of orthopedic mistakes in the course of life.

Flat Foot

What is a flat foot?

Many children are born with a flat foot. Since flat feet, or flat feet to be precise, occur mainly in childhood, a pediatrician or an orthopedic specialist can identify the predisposition to it at an early stage. Other sufferers who suffer from this misalignment of individual foot bones have contracted this abnormality in their lifetime. See sportingology for Meaning of APS in English.

The foot is flat on the subfloor when the affected person is standing. The arch of the foot, which normally has a hollow shape, is not or hardly present in flatfoot, so that the foot can be pushed through and the normal static bulge from the ball of the forefoot to the heel is missing. The symptoms that appear with flat feet are an accompanying fallen arch, a change in the edge of the foot in the form of a misalignment and painful symptoms that appear on the feet themselves, in the calves and other movement elements up to the back area.


A so-called congenital flatfoot usually occurs in connection with other malformations of the bony areas and can have genetic causes. Acquired flatfoot has many causes, including excessive body weight and unfavorable footwear. In addition, abnormalities in flatfoot consist not only in the bone changes themselves, but also in insufficient stability and performance of the so-called holding apparatus.

This particularly applies to insufficiently developed and impaired tendons, muscles and baths, which cannot maintain a normal arch of the foot. In addition, a predominantly sitting posture, standing for long periods, little movement and an extremely reduced walking of children without shoes, for example in sand, contribute to the fact that a flat foot can occur due to a reduced strain on the holding units.

In addition, diseases such as rickets, poliomyelitis and diseases from the neurological and rheumatic area can be considered as causes of flat feet.

Symptoms, Ailments & Signs

The symptoms of congenital flatfoot can be seen shortly after birth. The foot shows a malposition in which the outwardly curved sole and the bent, high heel are already clearly pronounced. In addition, the forefoot is spread outwards. As a result, the children learn to walk relatively late.

Movement is restricted. Pain is common with age. Other complaints, especially pain, do not occur. The symptoms of flat feet that occur in adolescence are different. There is usually more severe stress pain here. As a result, the young people affected develop a protective attitude and thus limp.

Without therapeutic measures, a significant restriction of movement with increasing pain can develop. In adults who develop flat feet, symptoms appear after heavy exertion. These are primarily felt when the arch of the foot drops. When the sole of the foot is completely on the ground, the pain goes back.

The pain usually occurs on the sole of the foot and on the inner edge of the foot. Due to the malposition, however, pain in the knee and hip area can also occur. Pressure points and pressure sores can form as a result of the intensive strain on certain areas of the foot, especially in overweight people. These also impair the ability to move and increase the sensation of pain.

course of the disease

In the case of an acquired flat foot, a flat foot develops from individual holding elements, which are actually responsible for supporting, stabilizing and maintaining the anatomically normal arch of the foot and are only insufficiently developed.

This causes the tension in these segments to relax and the arch to sag over time if these areas are not strengthened and exercised.

As a result, there is an insufficient cushioning effect, so that all subsequent and surrounding bones and joints are subject to constant compression and this is reflected in pain or changes in the foot. This condition is known as flat foot and it can be treated.


A flat foot can cause various complications. First of all, the foot malposition is accompanied by rapid fatigue of the feet. Often there is pain and signs of wear and tear on the bones and joints. If left untreated, the valgus deformity can lead to permanent joint damage and deformities.

This is accompanied by pain and malpositions, which in turn are associated with complications. The knees, hips and spine are also affected and are increasingly being overstrained due to the misalignment of the feet. This can lead to poor posture, overstretching of ligaments and tendons, and arthritic changes in the tarsal bones.

In general, the risk of osteoarthritis increases with a flat foot. Possible consequences are headaches and chronic complaints. In the long term, a so-called walking foot can develop or other deformations such as flat feet or splayfoot can develop. Complications can also arise when treating a flat foot.

A surgical procedure involves the typical risks and can cause bleeding and scars. In rare cases, further misalignments can occur. The prescribed painkillers can cause side effects and interactions. Therapeutic measures such as insoles can encourage sweating and, if used improperly, trigger further symptoms.

When should you go to the doctor?

Flat feet can be present at birth or develop later in life. However, in both cases it is advisable to see a doctor. With a surgical intervention and subsequent aftercare, an existing flat foot can be completely eliminated. If the person concerned decides against such treatment, considerable complications can be expected. A flat foot can disrupt the entire movement process, so that the affected person can complain of severe pain.

If medical treatment is consistently avoided, permanent consequential damage can also occur. Going to the doctor can no longer be avoided, because this is the only way to heal or recover without complications. If left untreated, there is also a risk that the foot will become deformed. The result: stabbing pain with even the smallest movements, so that a normal movement is not possible. These symptoms can only be alleviated and permanently eliminated with appropriate treatment.

Treatment & Therapy

Treatment of a flat foot or fallen arch is always possible and ideally consists of both passive and active treatment. The active therapy is based on regular, healthy strain on the foot muscles and on targeted physiotherapy exercises. These help to strengthen the musculoskeletal system and can both support freedom from pain and ensure partial regression of the flat foot and the associated deformities.

In the passive treatment of a flat foot, the orthopaedist uses the possibilities that can be implemented with suitable footwear to artificially stabilize the arch of the foot. This therapy usually involves wearing orthopedic insoles. Some of those affected who, as a result of illnesses they have survived, complain of a massive flat foot with pain extending into the back, are treated using an operative method. This is usually only considered from the age of eight and shows good results.


As a rule, there is no follow-up care for a flat foot. This is either due to the fact that the flat foot exists, but does not represent a limitation, or that it could be corrected surgically. Since no complaints are apparent, there is no need for scheduled examinations. Instead, the patient presents with acute signs.

Patients can make an active contribution to preventing another flat foot or counteracting the further development of a diagnosed malposition. You will be informed about suitable measures in an interview. Patients usually have to wear insoles to prevent complications.

In severe cases, doctors also prescribe orthopedic shoes and physical therapy to strengthen the muscles. In everyday life, those affected should avoid putting too much strain on their feet and prefer varied movement sequences. If people with flat feet have to use orthopedic aids permanently, they need new prescriptions on a regular basis.

The doctor then uses the opportunity to determine the status of the deformity. An appraisal is usually sufficient for this. In certain cases, the situation can also be analyzed with modeling clay, an electronic measuring plate or an X-ray image. Depending on the severity of the disease, the doctor and patient can agree on an individual rhythm for further presentations.

You can do that yourself

In order to live better with a flat foot in everyday life, there are shoe insoles that are specially adapted to the shape of the foot. They support the arch of the foot and distribute the load. Depending on the extent of the symptoms, custom-made orthopedic shoes help even more to cope with everyday life despite flat feet.

In addition to these commercially available means, simple exercises that can be easily incorporated into everyday life also help. A few minutes of regular exercise are enough to alleviate the symptoms. In general, all physiotherapy exercises that strengthen the lower leg and foot muscles and build up the arch of the foot are helpful. In order to achieve the best effect with the training, the exercises are carried out barefoot. However, as soon as the execution becomes painful, it must be stopped. Below are two example exercises.

Tiptoe stand: In this exercise, the person concerned stands up hip-width apart with their knees not fully locked. Then both heels are pushed off the ground, held in this position for ten seconds and then slowly rolled back onto the ground. The process is repeated three to five times. Different solid surfaces increase the training effect.

Cloth gripper: A cloth, for example a tea towel, is spread out on the floor. When sitting or standing, the patient pinches the cloth between the toes and ball of the foot. Then it is held in the air for five seconds. This exercise is repeated up to ten times on each foot. With consistent training, the weight of the cloth is increased more and more.