A history of Flat Feet

One of the first written accounts about flat feet comes from the Greek philosopher Aristotle (4th century BCE). He describes the condition and adds that flat footed people are likely to have a mischievous personality. This is to the contrary in Buddhism, in which flat feet are one of the 32 characteristics of a great man or Budha. During World War I and II, flat feet could disqualify enlisters from the British and US armies, as it was seen as a condition that could negatively impact one’s ability to serve. However, in the modern military flat feet are assessed on a case-by-case basis, considering the severity of the condition and its impact on the individual's ability to perform military duties.

What is a Flat Foot?

Flat feet, also known as pes planus, is a condition where the arches of the feet are lower than usual or absent. This condition can be congenital (present at birth) or acquired over time. It can affect one or both feet and vary in severity.

Are Flat Feet Bad?

Flat feet are not inherently bad, but can sometimes lead to problems depending on the severity and the individual. Here are some key points to consider:

Potential Issues with Flat Feet

• Pain and Discomfort: some people with flat feet may experience pain in the feet, ankles, knees, hips, or lower back.

• Overpronation: flat feet can lead to overpronation, where the foot rolls inward excessively while walking or running, potentially causing strain on the muscles and ligaments.

• Posture and Alignment: flat feet can affect overall posture and alignment, leading to imbalances and potential injuries.

• Increased Risk of Injury: individuals with flat feet might be more prone to injuries such as shin splints, plantar fasciitis, and Achilles tendinitis.

When Flat Feet Are Not Problematic

• Asymptomatic Flat Feet: many people with flat feet do not experience any pain or functional issues.

• Adaptation: some individuals adapt well to their flat feet and can participate in various activities without problems.

• Genetics and Development: flat feet can be a normal variant, especially in children, and may not always require intervention.

 When to Treat Flat Feet

• If there is pain involved

• If the flat foot is rigid: limited movement in ankle or foot, arch is absent in all positions (i.e. when not weightbearing, when up on toes)

• If the flat foot is acquired as an adult: progressive flattening of the foot's arch (may be linked to tibialis posterior dysfunction which requires treatment)

• If the flat foot is severe

Management and Treatment

• Orthotics: custom or over-the-counter orthotic inserts can help support the arches and reduce discomfort.

• Supportive Footwear: wearing shoes with good arch support and cushioning can alleviate symptoms.

• Exercises: strengthening and stretching exercises for the feet and lower legs can improve foot function.

• Surgery: in rare cases where flat feet cause significant problems and do not respond to conservative treatments, surgical options may be considered.

If you or someone you know is experiencing pain or discomfort due to flat feet, consulting with a podiatrist can provide personalised advice and treatment options.