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Flat feet (pes planus)

Pes planus · Plochá noha (pes planus)

What it is

The inner arch of the foot is low or collapses on standing; usually harmless in children, but in adults a failing tibialis posterior tendon can flatten it painfully.

Symptoms & signs

  • Arch that touches the floor
  • ache along the inside of the ankle
  • tired legs
  • shoes worn down on the inside
  • swelling behind the inner ankle bone
  • knee or back pain

🚩 Get help if…

  • see a doctor soon One foot flattening in an adult, with ankle pain or swelling
  • see a doctor soon Stiff, painful flat foot in a child
  • see a doctor soon Cannot stand on tiptoe on one leg
  • see a doctor soon Hot, swollen, red foot in a person with diabetes

Where it strikes

Medical treatment

  • Nothing if painless and flexible
  • supportive shoes and arch orthoses
  • physiotherapy for tibialis posterior
  • immobilising boot for an inflamed tendon
  • reconstruction for a rigid painful flat foot

Natural & lifestyle

  • Barefoot walking and toe exercises
  • calf stretching
  • weight control

Emerging & experimental

  • Subtalar implants in children
  • tendon transfer techniques

Alternative, off-label & anecdotal

Approaches used outside the guidelines, with what their supporters report and what testing has found so far.

  • Barefoot and minimalist shoes — studies show stronger foot muscles; contested for adults in pain mixed evidence
  • Short-foot exercise — small trials raise the arch early / small studies
  • Magnetic insoles — a controlled trial in foot pain (JAMA 2003) found no benefit not confirmed in trials

ICD codes