Flat Feet Symptoms, Causes & Treatment Options

Flat feet are a condition that can cause ankle, knee, hip, and back pain that can lead to injuries later in life. It can be caused by a prior injury to the foot or inherited from a parent. They may not cause symptoms or require treatment. In some cases, they may cause pain in other joints like the ankle, knee, and hips.

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  1. Overview
  2. Symptoms
  3. Potential Causes
  4. Treatment, Prevention and Relief
  5. When to Seek Further Consultation
  6. References

What Is Flat Feet?


Flat feet are a condition in which the arch has fallen or is not present. This article will discuss the potential symptoms of flat feet, the complications that may take place. It will also discuss the potential treatments for these symptoms. Flat feet are primarily treated by using arch-supporting shoes.

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Flat Feet Symptoms

Main symptoms

Flat feet do not cause symptoms in most people. In children, flat feet can cause foot, ankle, and leg pain as the foot rotates inward and alters the alignment of the joints of the legs. Flat feet are also more common among children and more frequently symptomatic if they do not resolve by adulthood. Among children, flat feet are either flexible flat feet or rigid flat feet. The former usually cause no symptoms and disappear by adulthood; the latter can cause problems that may require treatment. In adults, flat feet often cause foot, ankle and leg pain.

  • Foot pain: Flat feet can cause foot pain, particularly in the heel or arch of the foot.
  • Foot fatigue: After periods of use, it is common for individuals with flat feet to have pain at the heel, arch, or Achilles tendon of the foot.
  • Ankle swelling: Ankles can become painful and swell in individuals with flat feet.
  • Tight heel cords: The Achilles tendon, the cord that runs along the back of the foot, can become tight in individuals with flat feet.

Flat Feet Causes

Flat feet are inherited in most cases. This means that the genes passed down from an individual’s parents determine if he or she will have a flat foot or a foot with an arch. In some cases, diseases of the connective tissue like Ehlers-Danlos syndrome and Marfan syndrome predispose individuals to developing flat feet as weak connective tissue causes the arch to fall in. Finally, in some individuals, an injury to the foot like a fracture or a very severe sprain can cause the arch to fall during the healing process of the foot.

Familial inheritance

Flat feet in the majority of cases are inherited from parents. This means that parents that have flat feet transmit the genes that cause flat feet to develop to their children. Often this happens in the absence of a genetic connective tissue disease like Marfan syndrome, Ehlers-Danlos syndrome, or joint hypermobility syndrome.

Abnormal bone formation

In some cases, the bones of the feet can be formed or connected in such a way that the arch does not form, and the feet have some difficulty supporting the weight of the body. Three of the most common types of malformations are listed below.

  • Tarsal coalition: In tarsal coalition, some of the bones of the feet are fused together, and this can keep an arch from forming as the bones cannot articulate properly. This may be inherited and affect several generations of the same family.
  • Congenital vertical talus: Misalignment of the bones of the feet can cause improper formation of the arch. This is not the same as fusion and can sometimes cause a foot curve that bows downwards instead of upwards as in a normal arch. This is called a “rocker bottom foot” and is frequently associated with Down syndrome.


Injuries to the bones of the ankle or the bones of the foot are common causes of a dropped foot arch. Among these, some of the more common injury types are described below.

  • Lateral subtalar dislocation: In cases of a high-velocity injury, damage to the foot can lead to a dropped arch. Dislocation of the talus bone along the inside of the foot can cause a permanent loss of the arch of the foot.
  • Ankle injury: Injury to the ankle causing loss of stability can cause flat foot to develop. An increased rate of rolling of the ankle can also be caused by flat feet.

Connective tissue disorders

Disorders that weaken the connective tissue between bones and muscles and the connective tissue that connects bones are common causes of joint problems and alignment problems including flat foot. Among the most common causes of joint problems are disorders like Ehlers-Danlos syndrome, Marfan syndrome, and joint hypermobility syndrome.

  • Ehlers-Danlos syndrome
  • Marfan syndrome

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Treatment Options, Relief, and Prevention for Flat Feet


Most flat feet are treated through behavioral methods such as stretching properly before physical activity, taking over-the-counter pain medications, or resting appropriately between periods of exertion. Different types of shoes that offer arch support may help prevent inward rolling of the ankle and improve alignment of the foot overall decreasing the chance of a subsequent injury to the ankle or the knee.

Flat feet that are caused by poorly formed bones or connective tissue are usually treated with supportive devices that help raise the arch and decrease chances of injury. Severe flat feet caused by a permanent bone malformation can be treated surgically if they are symptomatic.


Flat feet are primarily genetic or inherited along familial lines. They cannot be prevented if they are inherited or genetic, but proper behavioral interventions, strengthening, and stretching can lower the chance of injury. Flat feet from connective tissue disease are common and also difficult to prevent for the same reason. Flat feet from a traumatic injury to the foot can be prevented by doing what is possible to prevent injury. This includes avoiding strenuous exercise when tired, wearing proper protective equipment and supportive footwear, and stretching before and after exercise.

When to Seek Further Consultation for Flat Feet

Flat feet are usually not emergent and symptoms can be prevented if they are identified and proper prophylactic treatment is applied. If you have new and consistently unexplained foot pain, you should seek medical evaluation. If you lose sensation in your feet, or they become cold and unable to move, you should seek emergency medical evaluation.