Flexible Flatfoot: Symptoms & Treatments

Flexible flatfoot is a progressive condition that typically occurs in children and adolescents. The arch of the affected foot is visible when sitting but collapses when standing. One of the most common types of flatfoot, people with this condition usually bring it into their adulthood as the symptoms may not surface or bother them until much later, when the tendon has deteriorated over the years.


Patients with some preexisting conditions are at higher risk of getting flexible flatfoot. Diabetes, rheumatoid arthritis and obesity put stress on the tendon that supports the arch, causing it to stretch or tear over time and eventually collapse under pressure.

Other factors like old age, injury to the foot, bunion, hammertoe and short Achilles tendon can also lead to flexible flatfoot.


The first signs of flexible flatfoot are pain and swelling along the inside of the ankle. As the condition worsens, the front of the foot and toes would turn outward and the heel rolled inward. If treatment is further delayed, the pain would shift to the outside of the ankle with the risk of developing arthritis. Patients are also likely to complain about pain along the shinbone, lower back and knee.


The doctor would first look out for the collapsing and returning of the arch when you stand and sit. Your feet are observed from the front and back to see how much the forefoot has turned outward. An X-ray, CT scan, ultrasound or MRI may be ordered depending on whether details on soft or hard tissue are required.


Non-Surgical Treatment:

Treatment would only be necessary when the symptoms have surfaced. Usually, non-surgical treatments are sufficient to relieve the symptoms. Methods may include the following:

  • Rest

Reduce or stop activities that aggravate the pain. Rest your feet more often and avoid standing and walking for too long.

  • Immobilization

A boot or cast helps to prevent weight bearing to allow the tendon to heal.

  • Orthotics

Orthotics are shoe inserts that can be customized to give support to the arch.

  • Losing Weight

If obesity is the cause of the condition, weight loss would help to relieve the pressure and pain.

  • Physical Therapy

Doing exercises stretch the Achilles tendon and provide stability to the joint.

  • Medication

Medication may be prescribed to reduce pain and inflammation.

Surgical Treatment:

If non-surgical treatment does not relieve the symptoms or if there are other problems such as a tendon tear or rupture, surgery would be required. Depending on the injury and severity, these methods might be considered:

  • Tendon Transfer
  • Foot Lift
  • Joint Spacer
  • Bone Fusion or Realignment

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