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Flat feet: what are they and do they matter?

Flat feet

Credit: istock

I often see people who tell me that they have “flat feet” — often after they’ve been fitted for shoes and the sales assistant has told them so.

Sometimes these people try their darnedest to start walking on the outside of their feet to rectify the “flatness” of their feet by lifting up their arch, and sometimes they go and buy orthotics from the local chemist. Do they need to do these things? Maybe not.

So, what are flat feet?

Usually the term “flat feet” refers to a foot posture that we medical people call “pes planus”, meaning flattening of the arch so that more of the bottom of the foot is in contact with the ground. Often, this posture happens when people roll their feet in from the ankle and rest more of their weight on the inside of their foot rather than the outside.

Are flat feet a problem?

Potentially yes, potentially no. Some people have had flat feet for their entire lives and don’t know until someone like us points it out. In this case, if there is no pain, and the foot, ankle, lower back and leg joints don’t seem to be taking on any excess strain, that person would seem to be coping well with their foot posture, and it doesn’t necessarily need to be changed.

Very rarely will whacking an orthotic into someone’s shoes be the “fix” for all of their problems; however, as part of a rehab plan and multi-pronged approach, orthotics can be useful in the right people.

If, however, this person has a history of a rolled ankle and has recently started wearing ballet flats or free-running shoes every day, and is developing arch pain, foot pain, ankle pain, knee pain etc, then altering the position of the flattened foot may help to improve their symptoms.

Sometimes flat feet can be a risk factor for plantar fasciitis (inflammation and pain of the connective tissue under our arches), however this will usually occur if someone who is very sedentary decides to become very active. In this case, foot strengthening and arch strengthening might be part of the rehab plan for that person’s entire lower limb, including ankle, knee, hip and lower back.

Very rarely will whacking an orthotic into someone’s shoes be the “fix” for all of their problems; however, as part of a rehab plan and multi-pronged approach, orthotics can be useful in the right people.

How to improve foot health and flat feet

Flat feet often begin in childhood. We have lots of little muscles in the underside of our foot, which help to hold up our arch. Just like any other muscle in our body, these little foot muscles can get a bit weak and lazy if they aren’t challenged.

When safe to do so, encourage your little ones to walk barefoot. This helps to strengthen up these little muscles, helping with foot and arch development which will flow into adult life.

Once we’re older, supportive shoes are important for those of us working on our feet all day. Ballet flats and high heels can over stress our feet and the wearing of such shoes should be kept to a minimum.

If you’re concerned about your “flat feet” or foot/arch pain, pop in and speak to your osteo or podiatrist. They will thoroughly assess the cause of your problem and provide solutions such as stretches/strengthening exercises, suggestions on footwear and, if warranted, suggestions on orthotics.

Keep well,




Dr Claire Richardson loves what osteopathy offers her patients and how it can help people of all different ages and backgrounds. Claire treats a wide range of patients, from the young through to the elderly, including office workers, athletes, pregnant women and tradesmen. Claire enjoys treating all musculoskeletal ailments, from sports injuries to postural problems. She employs a wide variety of techniques in her treatment, including soft tissue massage, dry needling, and joint and muscle manipulation where appropriate. As part of her treatments, Claire advises on contributing lifestyle factors such as activity and diet which enables her patients to have an optimal and speedy recovery.