Flat feet are feet whose inner arches are flat, and whose soles completely touch the ground when the person is standing.
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Flat feet can happen at any age, and babies are born with them. Babies have fatty pads in the soles of the foot and in front of the heel, which fills the arch and gives feet their flat appearance. By age 3 years, when they are walking properly, their feet no longer have a flat look. From ages 3 to 6 years, the muscles of the foot become stronger, the fat disappears, and an arch develops. If the arches have not appeared by about age 5 or 6—as happens with approximately one in every 10 children—a child is likely to have flat feet through adulthood.
If the soles of a person’s shoes are worn out on the inside edge, that person probably has flat feet. People may have flat feet but still have good muscle tone and no pain. If feet are extremely flat, a doctor may recommend orthotics (arch supports) in a firm shoe to enable the person to walk without foot strain.
For some people, flat feet are the result of congenital bone malformation, evident if the doctor takes x-rays. For others, flat feet develop later. Each day as people walk, they take 8,000 to 10,000 steps on pavement, floor, tile, and other surfaces. With each step a person takes, gravity-induced pressure puts three to four times the body’s weight on each foot. Over the years, the imbalance on the muscles of the feet may cause a disorder in the natural arch. Excessive weight or pounding stress may cause the longitudinal (lonj-i-TOO-di-nal) arch (which runs the length of the foot) or the metatarsal (met-a-TAR-sal) arch (which runs perpendicular to the longitudinal arch, from one side of the foot to the other) to fall, or flatten.
Other causes of flat feet are shoes that do not fit well, obesity, rickets, and metabolic disorders that may cause the arch muscles to weaken. In older adults, decreased exercise and increased weight can cause mechanical disturbances in the foot.
Flat feet in themselves are not a problem. But running on flat feet is almost like running on gelatin. Flat feet turn inward (overpronation*), causing legs to turn inward, and contribute to such “overuse” injuries as shin splints and back problems. Flat feet also can produce heel spurs*. If pain develops as a result of any of these conditions, flat feet and the problems they cause need treatment.
- * pronation
- is the rotation of the foot inward and downward so that in walking, the foot comes down on its inner edge.
- * heel spur
- is a bony growth under the heel that causes pain when a person walks.
Reducing pronation can help to prevent further problems. Experts recommend:
- Buying shoes with arch support.
- Buying shoes that are motion controlled, or stability shoes with a medial post.
- Avoiding shoes with lots of cushioning and little support.
- Avoiding uneven running surfaces like golf courses and trails.
Surgery is rarely recommended for flat feet alone.
In American slang, the term “flat-footed” is sometimes used to describe:
- A comment that is blunt and insensitive.
- Writing that is plodding and unimaginative.
- A police officer who “pounds the pavement” or “walks a beat.”
During World War II, young men who had flat feet were disqualified from military service because it was believed they could never make it in the infantry.
Tremarne, M. David, M.D., and Elias M. Awad, Ph.D. The Foot and Ankle Sourcebook: Everything You Need to Know. Lowell House, 1998.
American Podiatric Medical Association, 2 Chevy Chase Circle NW, Washington, DC 20005. The APMA’s website features information about bunions and other disorders affecting the feet. http://www.apma.org