Flat feet (fallen arches)

'Flat feet' is the term used when the arch of your foot is lower than normal. This condition is also called 'fallen arches' or 'pes planus'.

The foot usually has an arch shape. This means the middle of the inside of the foot doesn't touch the ground but the heel and ball of the foot do.

In some people, this arch doesn't form properly or flattens over time.

It's normal for babies and young children to have flat feet.

Flat feet don't always cause symptoms. Sometimes, flat feet can lead to:

• pain or tiredness in the feet, legs or ankles — especially during or after physical activity
• stiffness or swelling in your feet or ankles
• uneven wear on shoes, usually around the inside heel
• your child tripping or falling more often than other children

Flat feet happen when the arch on the inside of the foot is lower than usual or doesn't form properly. This is common in younger children and many grow out of it as they get older.

Flat feet can be caused by different things, including:

• normal development — most babies and young children have flat feet because they have a soft fat pad under the arch
• family history — flat feet can run in families
• health conditions — such as Ehlers-Danlos syndrome, cerebral palsy, juvenile arthritis and muscular dystrophy
• tight muscles or tendons
• obesity

If you or your child:

• is under 8 years old and keeps falling or has trouble walking because of flat feet
• is 8 years old or older and has pain or difficulty moving because of flat feet
• has stiffness, pain or a limp with their flat foot
• has only one flat foot

If you or your child has already seen a physiotherapist and your walking is still affected, it's a good idea to go back to your doctor.

If you have any other concerns about your feet, see your doctor.

To diagnose flat feet, your doctor will look at your feet while you're standing and walking. They may also ask about any pain or problems with walking, running or playing sport.

Sometimes, other tests can help diagnose flat feet, including:

• footprint tests — where your footprint is checked to see how much of the arch of your foot touches the ground
• imaging tests, such as an X-ray
• tests to rule out other conditions

If you have flat feet that aren't causing pain or problems, you don't need treatment.

If you have symptoms, treatment might include:

• orthotics (special inserts for your shoes)
• physiotherapy
• losing weight
• wearing more supportive shoes

Orthotics are sometimes known as arch supports. They can help to manage pain or injury that may come with having flat feet. A podiatrist can help you choose the right inserts for your shoes.

In some situations, your doctor may recommend surgery.

If you have flat feet, it's important to wear shoes that support your feet properly. Wearing supportive shoes can help reduce pain and tiredness in your feet.

Here are some tips when choosing shoes:

• Measure your foot's length and width.
• Make sure the shoes match the natural shape of your feet.
• Leave a little space between the end of your longest toe and the end of the shoe.
• Choose shoes with no heel or a low heel.
• Look for shoes that suit the activity you'll be doing.

Untreated flat feet can lead to problems with your:

• ankles
• knees
• hips
• lower back

Treatment can help prevent these complications.

Flat feet can't always be prevented.

You can keep your feet healthy by wearing shoes that fit well and support your feet. Avoid shoes that are too tight, loose or worn out.

Some people use orthotics to try to stop flat feet from forming. There is not enough evidence to show that this can prevent flat feet.

If you're worried about your feet or how you walk, talk to a doctor or health professional.

• Sydney Children's Hospitals Network has a fact sheet about flat feet in children.
• The Australian Podiatry Association can help you find a podiatrist.
• Australian Physiotherapy Association can help you find a physiotherapist.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with you 24 hours a day, 7 days a week.