Flatfoot is a partial or total collapse (loss) of the arch on the inside of the foot. It is one of the most common foot conditions we see, and it can be present from childhood or develop later in life. Shared characteristics of flatfoot include the toes drifting outward, the heel tilting inward, a tight Achilles tendon, and — in some cases — the development of a bunion or hammertoe over time as the foot's alignment shifts.
Not everyone with flat feet has pain, and many people live comfortably without ever needing treatment. Problems tend to arise when the altered alignment starts to place extra strain on the arch, ankle, or the tendons that support them.
Flexible flatfoot is one of the most common types of flatfoot. It typically begins in childhood or adolescence and can continue into adulthood. The hallmark feature is that the arch flattens out when standing and bearing weight, but reappears when the foot is lifted off the ground or is not bearing weight — hence "flexible." Over time, the tendons and ligaments supporting the arch can become further stretched, and some people develop symptoms as adults even if the flat arch caused no problems earlier in life.
Because a tight Achilles tendon and altered arch mechanics can affect the plantar fascia as well, flat feet often overlap with plantar fasciitis and Achilles tendonitis.
What are the symptoms of flat feet?
Many people with flat feet have no symptoms at all. When symptoms do occur, they can include:
- Pain in the heel, arch, ankle, or general foot area
- The ankle rolling inward (over-pronation) while walking or standing
- Shin splint-type pain along the front of the lower leg
- General fatigue or achiness in the foot or leg after standing or walking
- Low back, hip, or knee pain related to altered leg alignment
What causes flat feet?
Flexible flatfoot often runs in families and is related to how the arch and supporting ligaments develop. In adults, flat feet can also develop or worsen due to weakening of the posterior tibial tendon, which is one of the main structures supporting the arch — this is sometimes called adult-acquired flatfoot. Other contributing factors include obesity, prior injury, and conditions that affect the tendons and ligaments of the foot. If your arch has recently changed or you have new pain along the inside of your ankle, it is worth having your posterior tibial tendon evaluated.
How do we diagnose flat feet?
Diagnosis begins with a physical examination, watching how you stand and walk, and checking the flexibility and alignment of your arch and ankle. Your podiatrist will look at whether the arch reappears when you rise onto your toes or lift your foot off the ground, which helps distinguish flexible flatfoot from more rigid forms. X-rays may be used to evaluate the bones and joints of the foot, and in some cases additional imaging helps assess the condition of the supporting tendons.
Most flatfoot does not require surgery. Non-surgical treatment focuses on relieving strain on the arch and supporting structures, and may include:
- Activity modification to reduce stress on the foot during flare-ups
- Weight loss, where relevant, to reduce load on the arch
- Custom orthotics to support the arch and improve alignment — see our custom orthotics options
- Immobilization with a brace or boot for more symptomatic cases
- NSAIDs to reduce pain and inflammation
- Physical therapy to strengthen supporting muscles and improve flexibility
- Supportive, well-fitted footwear to reduce strain throughout the day
Surgery may be considered when pain is not adequately relieved by other treatments. If surgery is recommended, the specific procedure depends on the type and severity of the deformity, your age, and your activity level. Our physicians will always exhaust conservative options first and explain the risks and benefits of any surgical recommendation.
Most people manage flat feet successfully with orthotics, supportive footwear, and activity adjustments, often on an ongoing basis rather than as a one-time fix. If physical therapy or bracing is part of your plan, consistency is key to improving strength and reducing symptoms. When surgery is needed, recovery is longer and more involved, and your podiatrist will provide a personalized timeline based on the procedure performed.
When should you see a podiatrist about flat feet?
See a podiatrist if flat feet are causing pain in your foot, ankle, shins, or lower body, or if your arch appears to be changing over time. Getting evaluated early makes it easier to manage symptoms with conservative care before they progress. When you are ready, you can request an appointment at either of our Northern Utah offices.
Wasatch Foot & Ankle Institute is a locally rooted podiatry practice serving Farmington, South Ogden, and the surrounding Davis and Weber County communities. Our board-certified, fellowship-trained physicians focus exclusively on the foot and ankle, from everyday arch pain to complex reconstructive care.
That focus lets us offer the full range of flatfoot management under one roof — from custom orthotics and physical therapy to advanced surgical correction when it is truly needed — so your care can advance without a referral elsewhere. We treat patients from both of our clinics; learn more about our Farmington and South Ogden locations or call the office nearest you.
Medically reviewed by the physicians at Wasatch Foot & Ankle Institute. Our board-certified, fellowship-trained podiatrists provide foot and ankle care in Farmington and South Ogden, Utah. This page is for general education and is not a substitute for an in-person evaluation.
