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Flat feet (also called pes planus or fallen arches) is an informal reference to a medical condition in which the arch of the foot collapses, with the entire sole of the foot coming into complete or near-complete contact with the ground. In some individuals (an estimated 20-30% of the general population) the arch simply never develops in one foot (unilaterally) or both feet (bilaterally).

Flat Feet in Children

The appearance of flat feet is normal and common in infants, partly due to "baby fat" which masks the developing arch and partly because the arch has not yet fully developed. The human arch develops in infancy and early childhood as part of normal muscle, tendon, ligament and bone growth. Training of the feet, especially by foot gymnastics and going barefoot on varying terrain, can facilitate the formation of arches during childhood, with a developed arch occurring for most by the age of four to six years.

Flat arches in children usually become proper arches and high arches while the child progresses through adolescence and into adulthood.

Because young children are unlikely to suspect or identify flat feet on their own, it is a good idea for parents or other adult caregivers to check on this themselves. Besides visual inspection, parents should notice whether a child begins to walk oddly, for example on the outer edges of the feet, or to limp, during long walks, and to ask the child whether he or she feels foot pain or fatigue during such walks.

Children who complain about calf muscle pains or any other pains around the foot area, may be developing or have flat feet. Pain or discomfort may also develop in the knee joints. There is little debate, however, that going barefoot, particularly over terrain such as a beach where muscles are given a good workout, is good for all but the most extremely flatfooted, or those with certain related conditions such as plantar fasciitis.

Flat feet can be treated by insoles or custom orthosis. The earlier a child with severe flat feet gets orthosis, the more likely their foot will develop normally. Surgery can also be done for children with severe flat feet.



Flat Feet in Adults

Flat feet can also develop as an adult ("adult acquired flatfoot") due to injury, illness, unusual or prolonged stress to the foot, faulty biomechanics, or as part of the normal aging process. Flat feet can also occur in pregnant women as a result of temporary changes, due to increased elastin (elasticity) during pregnancy. However, if developed by adulthood, flat feet generally remain flat permanently.

If a youth or adult appears flatfooted while standing in a full weight bearing position, but an arch appears when the person dorsiflexes (stands on tip-toe or pulls the toes back with the rest of the foot flat on the floor), this condition is called flexible flatfoot.

Muscular training of the feet, while generally helpful, will usually not result in increased arch height in adults, because the muscles in the human foot are so short that exercise will generally not make much difference, regardless of the variety or amount of exercise. However, as long as the foot is still growing, it may be possible that a lasting arch can be created.

Flat feet can be treated by insoles or custom orthosis. Surgery can also be done for adults with severe flat feet.