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- The arch of the foot is a flexible arch with two points of support; when muscles and ligaments weaken, it sags under the weight of the body.
- An orthopaedic trauma surgeon manages flat feet: examines the foot, assesses gait and selects orthopaedic insoles or footwear.
- Plantography and X-ray of the feet show the imprint of the sole, the degree of flattening and the bone angles of the arch.
- Rapid fatigue of the legs, swelling by the evening and wear of footwear on the inner side are typical signs of flattening of the arch.
- Prolonged standing on the feet, excess weight, tight footwear and foot injuries increase the risk of developing flat feet in adults.
What is flat feet
Flat feet is a condition in which the arches of the foot flatten, and the sole touches the floor with almost its entire surface. Understanding exactly what changes in the foot and which circumstances trigger this process is important for understanding the next steps.
What happens in the body
The human foot is built like a flexible arch that rests on the heel bone and on the pads under the toes. Between these points of support a free space remains, and it is this that provides springiness when walking. When the muscles and ligaments that hold the arch weaken, the arch gradually sinks down under the weight of the body. Because of this, the foot rests on the surface with almost its entire sole, rather than on two points of support. A person begins to tire more quickly when walking, shoes wear out unevenly, and the gait becomes heavier. Gradually the load is redistributed to the shins and knees, which over time makes itself felt with unpleasant sensations. Changes can be noticed by how the inner edge of the sole wears down and how quickly the legs tire by the evening. If this is ignored, the flattening becomes established, and it becomes harder to restore the former shape of the arch.
What causes it to develop
- Hereditary predisposition: features of the structure of ligaments and bones are often passed down in families, so the condition is noticeably more common among close relatives.
- Weakness of the muscles and ligaments of the foot: when the muscular framework does not hold the arch, it sags under the weight of the body even under ordinary loads.
- Excess body weight: extra weight increases pressure on the arches with every step, and they gradually lose their shape.
- Wearing uncomfortable shoes: a tight last, a rigid sole or a high heel prevent the foot from working naturally and weaken its support.
- Prolonged static loads: standing on the feet for many hours without rest tires the muscles, and they stop supporting the arch.
- Foot injuries: past damage to bones and ligaments disrupts the integrity of the arch, so the feet should be protected from repeated bruises.
Who encounters this more often
Most often, flattening of the arches is detected in people whose work involves standing on their feet for long periods. Shop assistants, hairdressers, cooks and doctors spend most of their shift on their feet, and their feet experience constant pressure. Age also plays a noticeable role: over the years muscles and ligaments lose their elasticity, so the condition is more common in older people. In children the arches form gradually, and up to a certain age a flat foot is considered a variant of the norm. Excess weight adds load regardless of profession, and heredity increases the likelihood even with a calm lifestyle. Women more often wear shoes with heels and a narrow toe, which also affects the condition of the arches. If someone in the family has already had flat feet, it is worth paying closer attention to tiredness in the legs and choosing shoes with good support.
What symptoms can occur?
Flat feet can go unnoticed for a long time, and a person notices the first changes by chance. Knowing the typical signs helps you understand when discomfort in the legs is a reason for a planned visit and when you need to act urgently.
How it is noticed at the very beginning
Flat feet often manifest as rapid fatigue of the legs when walking, which is easy to put down to tiredness after a long day. Many people learn about it by chance during an examination or when discomfort appears after prolonged walking. Gradually, a heaviness in the legs is added to the fatigue, occurring even after usual exertion. By the evening, swelling may appear, which usually subsides by the morning. Sometimes the gait changes, and the person begins to place the foot differently than before. Shoes begin to wear on the inner side, which is noticeable on the sole and insole. If such signs repeat day after day, it is worth seeing an orthopaedic traumatologist without waiting for the pain to worsen.
Signs that occur most often
- Rapid fatigue of the legs: tiredness comes earlier than usual even after usual walking, and this interferes with the normal rhythm of the day.
- Pain in the foot or lower leg: unpleasant sensations appear after exertion and may gradually become more noticeable.
- Swelling by the evening: by the end of the day the foot swells, and in the morning the swelling usually decreases or goes away.
- Change in gait: the person begins to place the foot differently, and over time those around them notice this.
- Wear of shoes on the inner side: the sole and insole wear unevenly, which indicates a redistribution of load.
- Heaviness in the legs: the feeling of heaviness persists even after rest, so it is important to discuss this with a doctor at an appointment.
When to seek help urgently
Examinations and tests
Examination for flat feet begins with a doctor's examination and, if necessary, is supplemented by instrumental methods. Different diagnostic methods show the shape of the foot, its position under load and gait characteristics.
How the examination begins
The first stage in diagnosing flat feet is examination and palpation of the foot, during which the doctor assesses the shape of the arch, the condition of the muscles and ligaments. During the appointment, the specialist observes the person's gait, paying attention to the position of the feet when walking and the distribution of load. The doctor also checks the range of motion in the joints of the foot and ankle to understand how mobile these joints are. Palpation identifies painful areas, which may indicate overstrain of individual muscle groups. Then the symmetry of the feet is assessed: the difference between the right and left leg helps to clarify the nature of the changes. If the examination reveals flattening of the arch, the doctor proceeds to instrumental methods to confirm and clarify the data obtained. The information gathered during the examination determines which additional investigations will be needed in a particular case.
What is prescribed and what it shows
What to prepare for the appointment
- Discharge summaries: take previous doctors' reports, if you have them, so that the specialist can see the history of observations and not repeat stages already completed.
- Images: previous X-rays of the feet are useful for comparison, since they show how the bone angles have changed over time.
- Footwear: bring the pair you wear most often, because the wear on the sole reflects the distribution of load when walking.
- Observations: write down when you first noticed the changes and in which situations fatigue or discomfort in the legs appears.
- Questions: formulate in advance what you want to clarify with the doctor so that you do not forget anything important at the end of the appointment.
Which doctor should I see?
This section explains which doctor to consult for flat feet, what happens at the first appointment and what areas of care the treatment consists of. We will also look separately at which part of the result depends on the regularity of follow-up and on the patient's own actions.
Which specialist manages this condition
Flat feet are managed by an orthopaedic traumatologist, and when necessary a podiatrist and a paediatrician are also involved. The orthopaedic traumatologist assesses the shape of the foot, the gait and the distribution of load, compares the complaints with the examination findings and determines the degree of change in the arch. The podiatrist deals with the condition of the skin, nails and weight-bearing points, so their involvement is particularly noticeable with chafing and altered loads on the sole. The paediatrician manages children from the first months of life, monitors the development of the foot during the growth period and refers to an orthopaedist when deviations are found. If there is no specialist nearby, start with an orthopaedic traumatologist at the polyclinic at your place of residence or make an appointment with a paediatrician, who will suggest the further route. At the first appointment the doctor clarifies the complaints and history, examines the feet in a standing position and while walking, checks the range of motion and sensation. Then they explain what exactly is happening with the foot and discuss the options for care with you without imposing unnecessary procedures.
What the treatment consists of
- Selection of orthopaedic insoles: these products redistribute the load on the foot and reduce pressure in painful areas, so they are selected individually rather than bought at random.
- Physiotherapy: the procedures help relieve pain and improve the nutrition of the tissues; they are prescribed as an addition to the main measures, not instead of them.
- Therapeutic exercise: special exercises strengthen the muscles of the lower leg and foot that support the arch, and the result here depends on regular practice.
- Massage: working on the muscles of the lower leg and foot relieves tension and improves their tone, which noticeably makes walking easier and reduces fatigue by the evening.
- Surgery for pronounced disorders: surgical intervention is considered when conservative measures cannot cope with the pain and limitation of movement.
- Follow-up over time: the doctor assesses changes over time and adjusts the care, because the condition of the foot can change under load and with age.
What depends on the patient themselves
The regularity of follow-up and everyday habits determine how stable the improvement will be with flat feet. The selected insoles must be worn constantly, not occasionally, otherwise the load returns to its previous distribution. Therapeutic exercises should be performed at home between visits to the doctor, since muscles only strengthen with repeated work. Massage and physiotherapy are undergone in agreed stages, not all at once, and missed sessions noticeably reduce their benefit. Shoes with a firm supporting heel and a suitable last reduce the load on the arch during long walks. If new pain, swelling or rapid fatigue appear, it is important to tell the doctor about it rather than change the insoles on your own. Write down when and under what circumstances the unpleasant sensations occur, so that the conversation at the appointment is specific. Such a diary helps the doctor assess the dynamics more accurately and review the approach to care in good time.
What helps prevent an exacerbation?
Prevention of flat feet helps slow its progression and reduce the risk of complications. A person can influence the course of the condition themselves through habits, monitoring and regular check-ups.
What to change in your habits
Footwear with good arch support and a comfortable last reduces the load on the foot when walking. Regular foot exercises strengthen the muscles and ligaments that support the longitudinal and transverse arches. Weight control reduces the constant pressure on the arch and lessens leg fatigue by the end of the day. Prolonged static loads, when a person stands still for a long time, increase fatigue and discomfort in the feet. Avoiding such loads or alternating them with short breaks noticeably eases the condition. Seeking medical advice promptly when pain occurs allows habits to be adjusted in time and prevents the process from progressing. It is sensible to review your daily routine so that the load on the legs is distributed evenly.
What to keep under control
- Comfort of footwear: assess whether it supports the arch and does not squeeze the foot when walking, because an unsuitable pair increases fatigue.
- Regularity of foot exercises: perform them at a calm pace so that the muscles and ligaments receive a constant rather than one-off load.
- Body weight: keep an eye on it, since excess weight increases pressure on the arch and speeds up leg fatigue.
- Duration of static loads: note how much time you spend standing and try to alternate this with movement or rest.
- Onset of pain or discomfort: notice when and under what circumstances they occur, so that you can see a doctor in time.
How often to see a doctor
A regular check-up with a doctor is needed even when the feet are not bothering you and you feel well. The specialist assesses the condition of the arches, gait and distribution of load, which a person does not notice straight away. Over time, habits and weight change, and what suited you before may stop supporting the foot. The doctor will advise which exercises are appropriate right now and how to adjust everyday load. If pain or increasing discomfort appears, the visit should not be put off until the scheduled date. Such monitoring allows changes to be noticed in time and habits to be adjusted without letting the process progress. It is sensible to discuss a convenient schedule of check-ups with the doctor and stick to it.
What is worth remembering
A conversation about flat feet ends not with a diagnosis, but with a decision on what to do next. Below are the conclusions that help you not lose sight of the main thing and not harm yourself with hasty actions.
Main conclusions
Flat feet is a condition in which the arch of the foot stops performing its supporting role, and over time this affects the entire leg. It can be noticed by rapid fatigue when walking, heaviness in the legs by the evening, and changes in your usual footwear. It is impossible to assess the degree of flattening and its effect on the joints on your own; this requires an examination by a specialist. You should not put off a visit if the unpleasant sensations return day after day and interfere with ordinary activities. Flat feet in children and adults progress differently, so the approach to monitoring also differs. Relying on your own sensations without a medical assessment often leads to a person enduring discomfort for years. It is more sensible to undergo an examination once and then act according to a clear plan than to solve the problem at random each time.
