A flat foot exists when the sole of the foot flattens out. This deformity is quite common.
Flat feet arise when the arch of the foot does not develop during childhood.

Usually, this disorder occurs on both sides, but often one foot is more flat than the other.



There are 4 possible degrees into which flat feet are classified.

  1. degree, the footprint on the ground shows the middle and outer part, the inner side is slightly on.
  2. degree, the imprint shows a discreet, but not complete resting of the inside.
  3. degree, the inside completely touches the ground.
  4. Grad, this is the strongest form, in which the foot rests mainly on the inside.

Causes of flat foot

Newborns have a less rigid sole of the foot.
Children are born with flat feet.

Most children develop a normal arch within 10 years.

A small percentage of “benign” flat feet do not correct with growth.

Physiological flatfoot:
Abnormal development of the arch of the foot is caused by ligament weakness.
About 10% of adults have flat feet. Most have a flexible flat foot without symptoms.
Causes of flat feet are:

  • dysfunction or spasm of the posterior tibial muscle (common cause),
  • pan ligament rupture (rare),
  • muscle or tendon tear of the anterior tibial muscle (rare),
  • neuropathic foot (diabetes, polio or other neuropathy),
  • inflammatory arthropathy (rheumatoid arthritis),
  • Fracture.

Other factors

  • Footwear: Shoes that restrict the movement of the toes, high heels. Walking barefoot on the meadow, in the sand or on gravel can be useful.
  • The contracture of a calf muscle pulls the Achilles tendon. This can lead to flat feet or cause pain.
  • Overweight.
  • Marfan syndrome.
  • Ehlers-Danlos syndrome.
  • Down’s syndrome.
  • In some cases, it can be hereditary.

Symptoms of flatfoot

Depending on the cause causing the puncture, the patient may experience various symptoms, such as:

  • pain inside the foot and in the ankle joint (along the tendon of the posterior calf muscle),
  • ankle swelling,
  • increase in pain during movement and walking,
  • Difficulty walking or standing for long periods of time.

The heel bone can shift and press on the fibula (outer bone of the ankle joint). This causes pain on the outside of the ankle.

Irritated nerves cause numbness and tingling in the upper parts of the foot and toes.
Pain manifests itself in the following areas:

  • Ankle
  • entire foot,
  • Arch
  • Calf
  • Knee
  • Hip
  • Lower leg area.

How to recognize flat feet? Diagnosis

The doctor in question is the orthopedist.
Tests to examine the patient for flat feet:

  1. Moisturize soles of the feet.
  2. Stand on a material on which an imprint can be left (cement, sand).
  3. Look at the print. If the footprint can be seen in its entire form, it is flat feet.

If the child stands on its feet, they seem to be flat.
But when the child stands on his tiptoes, you can see a slight bulge.
This foot deformity is called functional or flexible flatfoot shape.
Often the problem solves itself as you grow up.

In the X-ray, you can judge the flat foot by measuring the Costa Bertani angle. This angle is formed by two straight lines:

  1. Connect the underside of the hallux to the tip of the lower/anterior ankle bone;
  2. From the ankle bone to the lowest and foremost point of the heel.

The normal angle is 125°. If it is larger, it means that it is a flat foot.

Complications and consequences

Physiological flat foot
Experts believe that the physiological flat foot does not cause problems for the foot.

Stiff flat foot
A flexible flat foot can stiffen and hurt. This can lead to problems such as inability to walk and the doctor might perform a surgical procedure.

Treatment of flatfoot and natural remedies

Non-surgical treatment
If symptoms of flexible flatfoot occur, the surgeon will recommend non-surgical treatment, including:

  • Change everyday activities. Avoid activities that cause pain and rest the feet after standing for a long time.
  • decrease in body weight. It is recommended to reduce excess weight.
  • Orthoses. The surgeon recommends insoles in the shoes. The insoles (or shoe soles) are custom-made and support the arch of the foot.
  • Medication. Nonsteroidal anti-inflammatory drugs (NSAIDs) reduce pain and inflammation.
  • Physiotherapy. Ultrasound and other physical therapies serve to temporarily alleviate the symptoms.
  • Changes to footwear. Wearing shoes with a thickening under the arch of the foot is very useful.

Exercises for rehabilitation of flat feet

Flat feet are a problem that shows up especially in children who wear shoes.
The best and easiest sport is walking barefoot on uneven ground.
You can perform the following exercises for gymnastic correction:

Pick Up
Small objects are placed on the floor (stones, plastic balls, cotton balls, etc.). Collect the objects with your feet and place them in a basket.

Toe toe gait
Walk on tiptoe, walk on your heels after a short break. This exercise is very helpful.

Curl Up
Start the exercise lying on the bed and bend your toes. Relax the muscles again and repeat. Perform this exercise several times.

your toes 
Stretch your feet and spread your toes like a fan.
Hold this position for a few seconds, then relax the muscles again.
This exercise stretches the ankles, calves, feet and heels.

Toes on the step
The starting position is standing, on a step or a sturdy stool that supports the weight. The sole of the foot stands on the step, with the tips of the toes protruding above the surface. The exercise consists of stretching and curving the toes.

Some objects are spread on the floor and slowly collected with the feet. After that, they are thrown as far as possible.

Dance movement
The exercise is performed on the side of the wall to have a support.

  1. Lift one leg.
  2. Then lift the heel off the floor.
    Only the tip of the foot touches the ground.
  3. Stay in this position for a few seconds and stand on both feet again.

Orthopedic shoes for flat feet

Not every shoe is suitable.
Shoes for flat feet have an elevation under the heel, which correctly supports the weight when walking. In addition, orthopedic shoes have soles that support the arch of the foot.

Depending on the severity of the deformity, many models of orthopedic shoes can be found on the market.
Keep in mind that wearing the right shoes reduces pain.

When is surgery necessary?

Surgery can be performed if the pain cannot be reduced by conservative treatment.
The best age to have surgery is about 10 years before growth is complete.
The operation consists of inserting a screw into the ankle, which prevents the rotation of the heel bone.
The procedure takes about 20 minutes and is performed under local anesthesia.

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