Flat Feet
Flat feet are common and don't necessarily need treatment. The important question is whether your foot posture and movement are contributing to pain or affecting how you function.
Flat feet, fallen arches, low arches, pes planus and hindfoot valgus are terms used to describe different aspects of a foot with a lower medial arch and, in some cases, a heel that tilts towards the midline.
Having a low arch does not automatically mean that something is wrong. There is considerable variation in foot shape and arch height within the general population, and many people with flat feet have no symptoms at all.
At MK Orthotics in Milton Keynes, we look beyond the appearance of the foot. We assess how your feet and lower limbs function during movement and whether particular tissues may be experiencing excessive or poorly distributed loads.
What are flat feet?
A flat foot, or pes planus, describes a foot where the medial longitudinal arch is lower than that seen in a conventionally arched foot.
You may also hear the terms:
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Flat feet
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Fallen arches
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Low arches
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Pes planus
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Pes planovalgus
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Hindfoot valgus
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Overpronation
These terms don't necessarily describe a diagnosis.
There is also considerable variation in what is considered a "normal" foot shape. Pronation itself is a normal movement of the foot during walking, helping the foot absorb shock and adapt to different surfaces.
The presence of pronation or a low arch does not, by itself, mean that the foot needs correcting.
Do flat feet cause pain?
Not necessarily.
Many people have flat feet without experiencing any pain or functional problems. If your feet aren't causing symptoms, there may be no reason to treat the shape of your feet simply because they look flat.
For some people, however, the way the foot moves and the loads placed on the tissues may contribute to symptoms.
Depending on the individual, painful flat feet may be associated with:
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Aching through the arch
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Heel pain
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Pain around the inside of the ankle
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Forefoot or ball-of-foot pain
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Ankle instability
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Achilles tendon problems
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Shin pain
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Fatigue or aching after prolonged standing or walking
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Pain when running or taking part in sport
The important question is not simply "Are my feet flat?"
It is:
"Are the way my feet function and the loads they are experiencing contributing to my symptoms?"
Is overpronation a problem?
Pronation is a normal part of walking.
The term overpronation is widely used, but there is considerable debate about exactly what constitutes excessive pronation and whether there is a single ideal amount of pronation for everyone.
There is such a wide variation in foot shape and movement within the population that simply measuring the height of someone's arch or observing the amount of pronation does not necessarily tell us whether there is a problem.
At MK Orthotics, we are more interested in how your foot and lower limb function during movement and whether particular tissues may be becoming overloaded.
What is the tissue stress model?
Rather than assuming that a particular foot position is inherently "wrong", a tissue stress approach considers the loads experienced by different structures during walking, running and other activities.
Your symptoms may be influenced by factors such as:
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How your foot moves
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How much activity you are doing
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Changes in your activity or training
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Joint movement
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Muscle strength and endurance
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Previous injury
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Footwear
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The way forces are distributed through the foot and lower limb
This is why two people with apparently similar flat feet can have completely different symptoms — and why they may require completely different treatment approaches.
What can cause painful flat feet?
There are a number of reasons why someone with flat feet may develop symptoms.
Sometimes symptoms are related to an increase or change in activity. At other times, restrictions in joint movement, muscle weakness, previous injury or changes affecting particular tendons or joints may be relevant.
It is also important to distinguish between flexible and rigid flat feet.
Flexible flat feet
A flexible flat foot may have a visible arch when the foot is not bearing weight, with the arch lowering when you stand.
This is common and may be completely symptom-free.
Rigid flat feet
A rigid or relatively stiff flat foot may have less ability to change position and may be associated with a different range of possible causes and symptoms.
If a flat foot is painful, particularly if it has recently changed shape or become increasingly difficult to use, further assessment may be appropriate.
Can flat feet cause other foot and lower-limb problems?
Flat foot posture may be associated with a range of foot and lower-limb symptoms and conditions.
These can include:
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Medial Tibial Stress Syndrome
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Posterior Tibial Tendon Dysfunction
However, an association does not necessarily mean that flat feet are the cause of the problem.
The relationship between foot posture, movement and symptoms is individual, which is why a clinical assessment is more useful than simply treating the appearance of a flat foot.
Can orthotics help flat feet?
They can help some people, but having flat feet does not automatically mean that you need orthotics.
An orthotic may be considered when an assessment suggests that changing the way forces are distributed through the foot and lower limb could help reduce symptoms or improve function.
The design of an orthotic should be based on the individual rather than simply prescribing the same type of arch support to everyone with flat feet.
Factors that may influence the decision include:
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Your symptoms
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How your feet move
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Joint range of movement
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Muscle function
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Lower-limb mechanics
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Your footwear
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Your usual activities
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Your previous injuries
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Any orthotics or insoles you have already tried
The aim isn't simply to "correct" a flat foot.
The aim is to understand whether the way your foot functions is contributing to your symptoms and whether an orthotic could form part of an appropriate treatment plan.
Do I need orthotics if I have flat feet?
Not necessarily.
If you have flat feet but don't have pain or functional problems, there may be no reason to treat them.
Even if you do have symptoms, orthotics may not be the only or most appropriate solution.
An assessment may identify other factors that could be addressed through exercise, footwear changes, activity modification or other treatment approaches.
At MK Orthotics, we don't prescribe orthotics simply because someone's feet look flat.
What happens during an MK Orthotics assessment?
Your initial assessment lasts approximately 90 minutes and includes a detailed assessment and video gait analysis.
We look at your feet and lower limbs as a whole and consider how they function during movement.
Depending on your symptoms, the assessment may include consideration of:
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Your symptoms and activity levels
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Foot posture
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Joint range of movement
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Muscle strength and function
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Lower-limb alignment
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Walking mechanics
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Running mechanics where appropriate
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Footwear
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Previous injuries
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Existing orthotics or insoles
Video gait analysis can help identify aspects of your walking or running pattern that may be relevant to your symptoms.
The aim is to understand the individual factors that may be contributing to your problem rather than simply deciding that your feet are "too flat".
What if I've already tried arch supports or orthotics?
If you've already tried insoles, arch supports or orthotics and they haven't helped, bring them with you to your assessment.
Your previous orthotics can provide useful information about what has already been tried and how your feet responded.
It may be that the orthotic was not appropriate for your particular symptoms, or that other factors such as joint movement, muscle function, footwear or activity levels also need to be considered.
A different orthotic is not necessarily the answer. The important thing is to understand why the previous approach didn't work.
Flat feet and foot pain
If you have flat feet and are experiencing pain, it can be difficult to know whether the shape of your feet is actually relevant to your symptoms.
The area that hurts may not always be the structure causing the problem, and several conditions can produce similar symptoms.
For example:
Heel pain may be related to plantar fasciitis, Baxter's nerve entrapment or tarsal tunnel syndrome.
Pain around the inside of the ankle may involve the posterior tibial tendon or other structures.
Forefoot pain may have a number of causes, including Morton's neuroma or metatarsalgia.
This is why we don't simply treat the shape of the foot. We assess the individual and consider the relationship between your symptoms, movement and the loads placed on your feet and lower limbs.
Related conditions
You may also find the following information useful:
Plantar Fasciitis & Plantar Heel Pain
Pain underneath the heel can have several possible causes. Our plantar fasciitis page explains the typical symptoms and why other conditions sometimes need to be considered.
Achilles Tendinopathy
Pain around the Achilles tendon may be associated with changes in activity, tendon loading and lower-limb mechanics.
Morton's Neuroma
Burning, tingling or numbness around the ball of the foot can sometimes be associated with irritation of an interdigital nerve.
Baxter's Nerve Entrapment
Nerve irritation can cause heel pain that may be mistaken for plantar fasciitis.
Tarsal Tunnel Syndrome
Compression of the tibial nerve can cause burning, tingling, shooting pain or numbness in the heel and sole of the foot.
When should I have my flat feet assessed?
Consider professional assessment if your flat feet are associated with:
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Persistent or increasing foot pain
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Pain when walking or running
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Pain after prolonged standing
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Recurrent ankle problems
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Repeated ankle sprains
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Increasing difficulty with activities you previously enjoyed
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New changes in the shape or position of your foot
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Symptoms that have not improved despite changing footwear or activity
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Previous orthotics that have not helped
If your symptoms are severe, your foot has changed shape suddenly, or you are unable to bear weight, appropriate medical assessment may be required.
Why choose MK Orthotics?
At MK Orthotics, we don't simply look at whether your arches are high or low.
We consider how your feet and lower limbs function and whether this relates to the symptoms you're experiencing.
Your assessment includes detailed biomechanical assessment and video gait analysis, allowing us to consider your walking and, where appropriate, running mechanics alongside your symptoms and activity requirements.
If orthotics are appropriate, they can be individually designed around your particular needs rather than simply providing a generic arch support.
And if orthotics aren't appropriate, we'll explain why.
Flat feet causing you problems?
You don't need to know whether your flat feet are the cause of your pain before contacting us.
A detailed assessment can help determine whether your foot posture and movement may be contributing to your symptoms and whether orthotics could be appropriate for you.
MK Orthotics is based in Blakelands, Milton Keynes.
Book an assessment
Initial assessment with video gait analysis — 90 minutes
If you've previously used orthotics or insoles, bring them with you to your appointment so we can assess what you've been using and consider why they may not have worked for you.