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Flat Feet


Flat feet are a common condition. The arch in the bottom of the foot continues to develop during childhood. Flat feet are normal in infants and toddlers, since the longitudinal arch is not yet developed. By adulthood, most people have developed normal arches.

Generally, flat feet are associated with pronation, where the ankle bones lean in towards the center of the body. Shoes belonging to children who pronate (after they’ve been worn long enough to be remodeled by the child’s foot) will lean toward each other when they are placed side by side, demonstrating the pronation.


Many people with flat feet do not experience any pain or other problems from their flat feet. If pain in the foot, ankle, or lower leg does occur, especially in children, the feet should be evaluated.


Flat feet or an abnormal tendon attachment in the foot can lead to a predisposition for tibialis posterior tendonitis, otherwise known as painful progressive flatfoot, or adult-acquired flatfoot, where the tendon at the back of the ankle (the tibialis[N1] posterior) becomes inflamed, stretched, or torn. If left untreated, tibialis posterior tendonitis may lead to severe disability and chronic pain.


Common treatments for tibialis posterior tendonitis are nonsteroidal anti-inflammatory medications, icing, physical therapy, supportive taping, bracing, and orthotic devices. Note: Please consult your physician before taking any medications. In some cases, surgery may be required to repair a torn or damaged tendon. In the most severe cases, operating on the bones of the foot to treat the flatfoot condition may be necessary.