Flat Feet (Pes Planus) – Causes, Symptoms & Treatment Options in Australia

Flat feet, medically known as pes planus or “fallen arches,” occur when the arch of the foot collapses, causing the sole to make full contact with the ground. While often painless, flat feet can sometimes lead to foot fatigue, discomfort, or postural issues if left unmanaged.

Understanding Flat Feet

Flat feet can be congenital (present from birth) or acquired later in life due to injury, tendon dysfunction, or other health conditions. In Australia, it’s one of the most common biomechanical issues treated by podiatrists and orthotists, particularly in adults who develop symptoms from prolonged standing, poor footwear, or age-related changes.

Causes of Flat Feet

Flat feet can arise from multiple factors that prevent arch formation or cause it to collapse over time:

• Genetics: A strong hereditary link exists—if one or both parents have flat feet, children are more likely to develop the condition.
• Tarsal Coalition: A congenital fusion of two or more foot bones that restricts motion and flattens the arch, often noticeable in adolescence.
• Posterior Tibial Tendon Dysfunction (PTTD): A key cause of adult-acquired flat feet. When the tendon supporting the arch becomes inflamed or torn, the arch may progressively collapse.
• Obesity: Excess body weight increases strain on the arches, accelerating flattening, particularly in adults.
• Arthritis: Conditions such as rheumatoid arthritis cause inflammation and structural damage in foot joints, weakening arch support.
• Injury: Severe sprains or fractures affecting bones and tendons can result in loss of arch height and function.
• Aging: As tendons and ligaments lose elasticity, the arch naturally weakens—common in adults over 40.
• Neuromuscular Disorders: Conditions such as cerebral palsy or muscular dystrophy can alter muscle tone, contributing to flat feet.
• Developmental Delays: In some children, arches never fully form, resulting in flexible or rigid flat feet persisting into adulthood.

Symptoms of Flat Feet

Many people with flat feet have no symptoms. However, when symptoms occur, they may include:

• Foot or arch pain, especially after long periods of standing or walking
• Swelling along the inside of the ankle
• Knee, hip, or lower back discomfort due to altered alignment
• Difficulty standing on tiptoes
• Excessive wear on the inner side of shoes (sign of overpronation)

How Flat Feet Develop

Flat feet may remain from childhood or develop later in life due to mechanical stress, injury, or degenerative changes. Identifying early warning signs—such as arch collapse or pain—is essential for effective management.

Diagnosing Flat Feet

Diagnosis combines clinical assessment and imaging to determine the cause and severity:

1. Physical Examination

• Visual Inspection: Observation of foot alignment and gait while standing and walking.
• Gait Analysis: Identifies excessive inward rolling (overpronation) or instability.
• Manual Testing: Checks arch flexibility, tenderness, and tendon integrity.

2. Imaging Techniques

• X-rays: Reveal bone alignment and structural deformities.
• MRI: Detects tendon injuries or soft tissue inflammation (useful for PTTD).
• CT Scans: Provides detailed images of complex bone structures and joint issues.

3. Other Diagnostic Tools

• Footprint Analysis: Determines the degree of arch collapse based on pressure distribution.
• Functional Tests: Includes toe-standing or single-leg raises to evaluate tendon function.
• Patient History: Evaluates previous injuries, family history, and footwear habits.

Treatment Options for Flat Feet

Flat feet usually do not require treatment unless they cause pain or interfere with mobility. However, persistent or symptomatic cases can be effectively managed with conservative or surgical interventions.

1. Non-Surgical Treatments

• Orthotic Insoles: Custom or prefabricated orthotic insoles support the arches and correct alignment. Algeos Australia offers a full range of orthotic insoles ideal for flat feet and overpronation.
• Supportive Footwear: Choose shoes with structured arch support and firm heels; avoid unsupportive shoes such as thongs or ballet flats.
• Physical Therapy: Exercises like heel raises, toe curls and towel scrunches strengthen intrinsic foot muscles and improve flexibility.
• Weight Management: Reducing excess body weight helps decrease pressure on arches and joints.
• Medication: NSAIDs such as ibuprofen can help relieve pain and inflammation.

2. Surgical Treatments

Surgery is reserved for severe or progressive flat feet that do not respond to conservative measures:

• Tendon Transfer: Replaces or reinforces a damaged posterior tibial tendon to restore arch support.
• Osteotomy: Bone realignment to correct deformity and rebalance the foot structure.
• Arthrodesis (Fusion): Fusing selected joints for stability and pain reduction in advanced deformity.
• Lateral Column Lengthening: Involves bone grafting to lengthen the lateral side of the foot and rebuild the arch.

3. Lifestyle & Home Remedies

• Foot Exercises: Strengthening and flexibility routines help maintain foot stability.
• Rest & Ice: Reduces inflammation after overuse or activity-related pain.
• Massage & Stretching: Improves circulation and relieves tightness in supporting muscles.

4. Complementary Approaches

• Chiropractic Care: Some patients report improved alignment and reduced pain following chiropractic adjustments.
• Acupuncture: May provide relief from chronic pain and inflammation, though evidence remains limited.

Prevention & Management

Although flat feet cannot always be prevented, certain measures can reduce risk and discomfort:

• Maintain a healthy body weight to reduce strain on feet.
• Wear supportive footwear, especially during prolonged standing or walking.
• Incorporate regular stretching and strengthening exercises for feet and ankles.
• Replace worn shoes or insoles regularly to maintain support.

When to Seek Medical Help

Consult a GP or podiatrist if flat feet cause persistent pain, stiffness, weakness, or numbness, or if the condition develops suddenly. Early intervention helps prevent long-term complications and improves functional outcomes.

Conclusion

Flat feet are a common but manageable condition. While many Australians experience no symptoms, some may develop discomfort or secondary issues related to gait and posture. Understanding the causes, recognising symptoms early, and using orthotic support can significantly improve comfort and mobility. Whether through orthotic insoles, physical therapy, or—in rare cases—surgical correction, effective solutions are available to restore balance and prevent future pain.

Explore Algeos Australia’s range of insoles and orthotic devices for professional-grade support designed to manage flat feet and enhance everyday comfort.