It is estimated that as many as 30 percent of people in the United States suffer from some degree of flat feet, or fallen arches. For the majority of these individuals, this condition doesn’t cause any problems. However, for those who do suffer issues, especially pain that is caused directly by their flat feet, a referral to a Pensacola orthopedic specialist is vital before long term issues begin.


“Normal” feet have arches that run along the entire length of their inner side. A flat foot has little or no arch at all. The forefoot tends to rotate outwards (abduction), and the heel tilts outwards (valgus) when walking or standing.

Many people with fallen arches experience no side effects or pain. However, when the connecting muscles and ligaments are strained, you may experience pain in your feet. You might also experience pain in the leg joints as a result of a flat foot. In certain cases, the foot rolls in too much while walking (overpronation). This can at times, be related to weight gain.


We are all born with flat feet and the arches develop over the course of childhood. For some, however, this development just doesn’t occur.

Much of the development of the foot is determined by genetics; some people just have flat feet and the condition tends to run in families. However, flat feet also has a great deal to do with the shape of the bones and the supporting muscles, tendons, and ligaments.

A weak arch, arthritis, pregnancy, diabetes, muscle disorder, or an injury are also causes of flat feet, as is simple wear and tear and aging.

One of the main reasons for the onset of flat feet later in life, is an issue with the dysfunction of the tibialis posterior tendon. This tendon is essential in terms of foot alignment and if it ruptures or weakens, the foot rolls in and flat foot presents itself.

The condition can also develop over time. Generally, the onset can be seen during the forties and fifties.


It is important to see your general practitioner to ask for a referral to a Pensacola ankle and foot specialist if:

  • you are suffering pain. Flat feet can cause even small amounts of pain in various areas of the body. This is as a result of body weight being unevenly loaded and also due to poor gait. If you suspect that your feet are flat and you are suffering from headaches, back pain or knee pain, it could be the structure of your feet that’s causing the issue.
  • your shoes are wearing out very quickly.
  • your feet feel weak.
  • your foot feels hypermobile or stiff.

Flat feet-related problems are classified in terms of stages. Each stage defines what specific treatment should be carried out.

Stage one. Stage one is characterized by tendon inflammation with no other obvious deformity. Diagnosis is made by physical examination and is confirmed via MRI or ultrasound.

Stage two. The flat foot is becoming more severe however there is no arthritis or stiffness present.

Stage three. Arthritis and stiffness is present in the foot, which is becoming increasingly more painful.

Stage four. When stage four is reached arthritis will have spread to the ankle joint.


During stages one and two of the disorder, pain can be often be resolved and your walk corrected through rest, orthotics, insoles, and sometimes physiotherapy.

Surgery by a Pensacola orthopedic surgeon may be required in severe cases, and may include:

The calcaneal osteotomy. Known as the ‘heel shift’, this involves moving the large bone at the back of the heel (calcaneus) back into alignment and securing it with screws.

A tendon transfer. This is considered when the tibialis posterior tendon is badly damaged. A tendon is taken from a smaller toe and transferred behind the medial malleolus. Toe function will not be affected and patients make a full recovery.

Fusion. During stages three and four of a flat foot condition, joint fusion must be considered to eliminate pain effectively.

Frequently Asked Questions

Q: How do I know if I have flat feet?

If you're experiencing pain in your feet, several tests can assist in determining whether or not you have flat feet. Below are two of these tests.

  1. Wet sand test. With this test, you'll walk through wet sand barefooted. Look at your footprints. If they are full or your entire footprint is in the sand, you're flat-footed. Any footprints where your arch didn't make an impression in the sand, you're probably not flat-footed.
  2. Shoe evaluation. Place your shoes on a table that's flat and take a look at them from behind at eye level. If you notice the inside of your sole has more wear, particularly in the area where your heel is, chances are you're flat-footed.

Q: Can flat foot cause pain In other areas of the body?

Your legs may turn inward unnaturally if you have flat feet. When your legs do this, it can increase your risk of injuries typically linked to stress (i.e. heel spurs, shin splints) and overuse. Fallen arches may also cause you to develop problems in your back. Additionally, you could develop:

  • Swollen ankles
  • Pain and discomfort in your feet and ankles
  • Knee problems caused by misalignment
  • Leg discomfort and pain, particularly when you're active

Any of these things can cause you to live an unproductive life because of the pain and discomfort. And this can lead to weight gain and more health issues.

Q: Why does my child have flat feet?

Many babies have flat feet when they're born that continue throughout their childhood. The reason for this is because kid's joints and bones are flexible and this can cause flat feet when standing. Younger babies' arches of their feet are often hidden since they tend to have a fat pad on the inner border of their feet. Their feet might also turn out which causes them to put more weight on the inner side of feet and causing them to look even flatter.

Q: What are the benefits of shoe inserts for flat foot?

Over-the-counter insoles and proper shoes can help alleviate and prevent discomfort and pain. If OTC insoles don't improve your flat feet symptoms effectively, you can have custom-made orthotic braces or devices made specifically for you which will help you get the most support in the area where your arch is.

Q: What is the best age to consider surgery for flat foot?

There are three types of flat feet surgery that your orthopedic surgeon may perform. These are:

  1. Bone cuts
  2. Soft tissue procedures
  3. Bone infusions

Depending on your age, the severity of your flat foot and if it's stiff will help the orthopedic surgeon determine how to fix it. Generally, kids grow out of flat feet by the time they're 5 years old. If they don't the doctor may recommend surgery.

Q: How can you prevent flat feet if caught on time, is it possible?

Practicing good foot care can help prevent flat feet. Buy orthopedic arch-support inserts that are labeled "Arch Support." Change up your shoes daily. You don't want to wear the same unsupportive shoes every day since this act can result in your feet over-correcting for the absence of the shape and lack of support, leading to fallen arches.

Avoid high heels that leave you balancing on a spike and skinny heels. Heels can change your alignment and center of gravity and when you wear them every day, they can cause your arches to be nearly useless. You can have your feet fitted in a shoe specialty store to find shoes that prevent pronated feet. Last, lose weight — extra body weight puts more pressure on your feet and worsens flat feet.