Flat Feet (Pes Planus)

Flat feet, also known as Pes Planus, is a common condition in which the arch of the foot is lower than normal or completely absent. While many people with flat feet have no symptoms, others may experience pain, fatigue, instability and difficulty participating in sports or prolonged walking.

At the Foot & Ankle Centre, Dr Anand Jadhav provides comprehensive evaluation and personalised treatment for both children and adults with flatfoot deformity. Treatment ranges from conservative management and customised orthotics to advanced reconstructive surgery for severe or painful deformities.

What are Flat Feet?

The arch of the foot acts as a natural shock absorber, helping distribute body weight during walking and running. In people with flat feet, the arch partially or completely collapses, allowing the sole of the foot to come into contact with the ground during standing.

Flat feet may be:

• Flexible Flat Feet – the arch appears when standing on tiptoes or when the foot is not bearing weight
• Rigid Flat Feet – the arch remains absent even when standing on tiptoes and is often associated with underlying bone or joint abnormalities

What Causes Flat Feet?

Flat feet may be present from childhood or develop later in adult life.

Childhood Flat Feet

Flat feet are common in infants and young children because the arches develop gradually during growth. Most children develop a normal arch by early childhood and do not require treatment unless symptoms are present.

Adult Acquired Flatfoot

In adults, flat feet may develop due to:

• Age-related weakening of the foot structures
• Posterior Tibial Tendon Dysfunction (PTTD)
• Previous foot or ankle injuries
• Repeated ankle sprains
• Arthritis
• Diabetes
• Obesity
• Hereditary ligament laxity
• Connective tissue disorders such as Marfan Syndrome or Ehlers-Danlos Syndrome

In children, a rigid and painful flat foot may occasionally be caused by tarsal coalition, a condition in which two or more bones of the foot are abnormally joined together.

Symptoms of Flat Feet

Many people with flexible flat feet remain symptom-free throughout life. However, symptomatic patients may experience:

• Pain along the arch of the foot
• Pain around the inner or outer side of the ankle
• Tired or aching feet after prolonged standing
• Swelling around the ankle
• Difficulty walking long distances
• Recurrent ankle sprains
• Difficulty participating in sports
• Progressive flattening of the foot

Children may complain of foot pain after physical activity, while adults often notice increasing discomfort with prolonged standing or walking.

Diagnosis of Flat Feet

A thorough assessment is essential to identify the underlying cause and determine the most appropriate treatment. Evaluation includes:

• Detailed medical history
• Clinical examination
• Assessment of foot alignment
• Gait analysis
• Tiptoe test to distinguish flexible from rigid flat feet
• Examination of the ankle, knee and spine

Investigations may include:

• Weight-bearing X-rays
• CT Scan (particularly for suspected tarsal coalition)
• MRI Scan (to assess tendons, especially the posterior tibial tendon)

These investigations help identify arthritis, tendon injuries, bony abnormalities and the severity of the deformity.

Non-Surgical Treatment for Flat Feet

Most patients with flexible flat feet do not require surgery.

Activity Modification

Reducing activities that worsen symptoms while maintaining general fitness.

Custom Orthotics

Medial arch support insoles help improve foot alignment, reduce strain on the supporting structures and provide greater comfort during walking.

Supportive Footwear

Well-fitted shoes with good arch support improve stability and reduce fatigue.

Physiotherapy

A structured rehabilitation programme focuses on stretching tight calf muscles, strengthening the foot and ankle muscles, improving balance, gait correction and functional rehabilitation.

Medication

Pain-relieving and anti-inflammatory medication may be prescribed when symptoms flare up.

Children with painless flexible flat feet usually do not require treatment and can continue normal activities, including sports.

When is Surgery Recommended?

Surgery is considered when:

• Pain persists despite comprehensive conservative treatment
• The deformity continues to progress
• Walking becomes significantly impaired
• The foot becomes rigid
• There is associated arthritis or tendon failure
• Tarsal coalition causes persistent symptoms

The aim of surgery is to restore alignment, relieve pain and preserve long-term foot function.

Flatfoot Reconstruction

Modern flatfoot surgery is tailored to the individual patient and may involve one or more procedures, including:

• Calcaneal (heel bone) osteotomy to realign the foot
• Lateral column lengthening
• Tendon repair or tendon transfer
• Achilles tendon lengthening
• Ligament reconstruction
• Midfoot procedures
• Joint fusion (arthrodesis) for severe or arthritic deformities

Rather than relying on a single operation, treatment is customised to correct the underlying cause of the deformity and restore a stable, well-aligned foot.

Recovery After Surgery

Recovery depends on the procedures performed. Most patients can expect:

• Immobilisation in a cast or protective boot
• Elevation of the operated leg to reduce swelling
• Non-weight-bearing with crutches or a walker for approximately 6–8 weeks
• Follow-up X-rays to monitor bone healing
• Progressive physiotherapy
• Gradual return to walking, work and sporting activities

Full recovery may take several months, but most patients experience significant improvement in pain, foot alignment and walking ability.

Why Choose Dr Anand Jadhav?

With over 30 years of orthopaedic experience and 12 years of specialist practice in the NHS, United Kingdom, Dr Anand Jadhav provides comprehensive treatment for adult and paediatric flatfoot disorders using the latest evidence-based techniques. His expertise includes:

• Flat Feet (Pes Planus)
• Posterior Tibial Tendon Dysfunction
• Flatfoot Reconstruction
• Foot & Ankle Osteotomies
• Tarsal Coalition
• Sports Foot Disorders
• Comprehensive Rehabilitation

Every patient receives an individualised treatment plan aimed at relieving pain, restoring foot alignment and helping them return to an active, pain-free lifestyle.

Frequently Asked Questions (FAQs)

Do all flat feet require treatment?

No. Many children and adults with flexible flat feet have no symptoms and require only observation. Treatment is recommended when flat feet cause pain, difficulty walking or progressive deformity.

Can orthotics cure flat feet?

Orthotics do not permanently change the shape of the foot, but they can improve alignment, reduce pain and provide better support during daily activities.

Is surgery always necessary?

No. Surgery is reserved for patients with persistent pain, progressive deformity, tendon dysfunction or rigid flat feet that do not improve with conservative treatment.