What to do about flat feet

Dear Alice,

I've known I was flat-footed for as long as I can remember, but I don't actually know what health risks come along with this condition. It's supposed to be bad for my joints... my spine maybe... and while it's been convenient to blame my back pain or difficulty running on my flat feet, I'm not sure if those are legitimate complaints. What are the health effects of flat-footedness, and what should I do to correct them? I've never seen a podiatrist or anything like that.

Dear Reader,

Sounds like those flat feet of yours have become your archenemy! In fact, it’s all about the arches here (or in your case, lack there of). Flat footedness is a condition that occurs when the tissues connecting the joints in your foot (known as tendons) aren’t tight enough to create a strong arch. While most people’s tendons begin to tighten in early childhood, people with flat feet either haven’t developed an arch at all or have developed only a slight one. This means that when you stand up, the soles of your feet rest entirely on the ground. Without that arch, your feet are flying sole-o! Unless flat feet are causing pain, there's no need to consider treatment options. However, there are a few ways to ease discomfort as it arises.

Although it sounds like you’ve had flat feet since childhood, which is known as flexible flatfoot, people can also develop flat feet as adults. This development is classified as rigid flatfoot and can happen simply as a result of time — after years of walking, running, and jumping, a person’s tendons can become loose enough for their arches to fall. Certain factors increase the likelihood of developing flat feet, including foot injuries or health conditions such as diabetes, obesity, or rheumatoid arthritis. 

Whether you’ve had flat feet forever or your arches have fallen as an adult, this condition can lead, in some cases, to various aches and pains, which could explain your complaints about back pain and difficulty running! Generally, being flat-footed has no health effects, but while many people with flat feet report no problems, joint or body pain like you’ve described isn’t uncommon. People with flat feet may experience pain from the foot or ankle up to the knee, hip or lower back due to poor alignment of the ankles and knees. Some with flat feet also report swelling of the arch, or foot fatigue. Being flat-footed may also cause an individual to develop an abnormal pattern of walking. 

If you notice swelling or pain after doing certain activities, you could try icing your feet and staying off of them for a couple hours (movie marathon, anyone?). You might also consider using an over-the-counter pain reliever, such as ibuprofen, that can help reduce inflammation. If you feel like going for a jog, it may help to avoid running on concrete, which can put more pressure on your feet. Instead, try running on grass or switch up your workout and take up yoga, swimming, or another low-impact activity to prevent excess strain on your arches.

To reduce pain, you may also want to make sure that any shoes you wear are supportive of those flat feet of yours. In some cases, shoe inserts might help. You can find shoe inserts at many drugstores, or you can visit a podiatrist who could make recommendations or fit you with orthotics (a customized type of shoe insert). A health care provider might also show you specific stretching techniques that can help manage your discomfort. It might also be helpful to make an appointment with a podiatrist to discuss your options for relieving pain. Individuals with severe pain that can't be treated using medication, inserts or stretches may be eligible for arch surgery, as a last resort, but it would require a consultation with a health care provider to figure out if you'd be eligible for such a procedure.  

Take care of yourself, and just remember that learning to work with those flat feet can be quite a feat in itself!

Last updated Jun 17, 2022
Originally published Feb 13, 2014