Flatfoot in Adults: Symptoms and Solutions

Adult flatfoot, a condition in which the foot arch collapses or is noticeably low, is much more than just an altered appearance. The collapse of the foot arch changes the way the foot absorbs shock and supports the body. These changes can cause flatfoot pain, tiredness, and activity limitations. Some people with flat feet have no symptoms, but others notice progressive pain and discomfort when walking, standing, and may have associated knee or lower back issues.

Treasure Valley Foot & Ankle evaluates adult flatfoot regularly as we assess patients with progressive flatfoot symptoms such as foot and ankle pain, changes in balance, or uneven shoe wear patterns. Learn more about the potential causes of adult flatfoot and the available treatments so that the condition does not get worse.

What Is Adult Flatfoot?

Flatfoot occurs in adults when the inner foot arch lowers or flattens when bearing weight. The arch may remain present when sitting but collapse or flatten when standing or walking. This changes the alignment of the foot and typically causes the heel to roll outward, increasing stress and strain on the ankle and surrounding joints.

The most common cause is posterior tibial tendon dysfunction. The posterior tibial tendon runs along the inside of the ankle and supports the arch during walking and standing. It can become overstretched or damaged over time and eventually lead to the gradual collapse of the arch.

Other common causes of flatfoot include arthritis, prior injury to the foot or ankle, naturally loose ligaments or tendons, or longstanding biomechanical stresses from sports or certain occupations.

Common Symptoms Associated with Flatfoot in Adults

Symptoms are typically progressive and worsen over time. Many adults notice a dull ache along the inside of the ankle or arch, particularly after prolonged standing or walking. Swelling or puffiness along the inside of the ankle is also common, as is foot and ankle fatigue or discomfort that sets in more quickly during daily activities.

With time, you may have difficulty standing on tiptoe, lose balance when walking on uneven surfaces, or notice that your shoes do not fit the same. Some people develop aching on the outside of the foot or ankle, which can occur as these joints are compressed from changes in foot alignment. Pain may also radiate to the knee, hip, or lower back as the body tries to compensate for the changes in foot mechanics.

Diagnosis of Flatfoot in Adults

Diagnosis is based on a thorough physical exam. The healthcare provider will assess arch height while sitting and standing, the alignment of the heel and ankle, your walking pattern, and your foot and ankle strength. They may also perform a single-leg heel raise test, which requires you to stand on one foot and rise onto the toes. This maneuver helps assess the function of the posterior tibial tendon.

Imaging is often used to confirm the diagnosis and assess severity. Weight-bearing X-rays demonstrate how bones align under load. Ultrasound or MRI can also be used to assess tendon damage and inflammation.

Treatment for Flatfoot in Adults

Conservative or non-surgical treatment is an excellent option for most adults with flatfoot, particularly when implemented early on. Footwear should be supportive, and your podiatrist may recommend specific styles. Shoes should have a firm heel counter, stable sole, and inherent arch support to control excessive motion and decrease strain.

Arch supports or custom orthotics help distribute pressure and improve overall alignment.

Many patients find that the quality of life improves within a few weeks of wearing supportive shoes and orthotics consistently. Physical therapy with a focus on strengthening the posterior tibial tendon, intrinsic foot muscles, and improving calf muscle flexibility can also help. These exercises help stabilize the arch and build up walking and standing endurance.

Modification of activities is an important aspect of treating flatfoot in adults. It is important to avoid high-impact exercise during flare-ups and instead focus on low-impact activities to prevent further worsening of symptoms. Weight loss and management are also important, as just a few pounds can make a difference in reducing the stress on the feet.

Surgical Options for Flatfoot in Adults

Surgery for flatfoot in adults is usually a last resort after pain has persisted or deformity has progressed in the face of appropriate conservative care. The type of procedure performed depends on the flexibility of the foot and the health of the tendon, joints, and surrounding structures. Tendon repair or transfer and realignment or joint stabilization procedures are among the most common.

Surgery for flatfoot in adults is typically successful. However, recovery from the surgery takes time and is dependent on the specific procedure performed. Rehabilitative therapy and a commitment to sticking with recommended protocols are vital to achieving a positive outcome.

Living Well With Flatfoot

Living with adult flatfoot does not have to limit your activities or lifestyle. With the right combination of appropriate footwear, orthotic support, exercise, and professional care, most adults with flatfoot can enjoy comfort and activity.

The key to managing the condition is early evaluation, which can help prevent worsening or the need for more invasive treatment.

Treasure Valley Foot & Ankle works closely with patients to determine which treatments, supports, and activity modifications can help with both symptoms and long-term foot health.

Frequently Asked Questions

Is flatfoot normal in adults? Some adults are born with flat feet or naturally low arches. Pain, swelling, or function changes are not normal with flatfoot and should be assessed by a podiatrist.

Can flatfoot get worse over time? Yes. Adult flatfoot can slowly progress if not treated and result in joint damage, chronic pain, and balance and activity issues.

Do orthotics help flatfoot pain? Custom or well-fitting arch supports are highly effective for reducing flatfoot pain and improving foot alignment, particularly with flexible flatfoot.

When do I need to see a podiatrist for flatfoot? If your foot or ankle pain lasts more than a few weeks, progressively worsens, or impacts your ability to walk or work, it is time to see your podiatrist.

What flatfoot treatments are available in Idaho? Treasure Valley Foot & Ankle provides custom orthotics, physical therapy, supportive footwear guidance, and more advanced treatment options if needed.