Have you ever stood without shoes and felt your whole foot touching the floor, as if there was no arch at all? If so, you might have flat feet, which some people call fallen arches. It is a common thing among both kids and adults. For some, flat feet are just how they are, and they do not cause any trouble. But other people find that flat feet can make their feet hurt, their legs feel tired, and after a while, they might even have problems with their back or knees. When your feet are not aligned correctly, your body has to change how it moves, and that can cause aches and pains later on.

Understanding the Anatomy of Your Feet

Your feet are pretty amazing. Each foot is like a complicated machine that lets you move around. They are strong and bendy, and they hold up your whole body when you are walking, running, or just standing.

Inside each foot, there is a lot going on:

Bones: Each foot has 28 bones. These bones fit together to form the arch of your foot and give it its shape. They also help you balance and move smoothly. Each of these bones needs to be in the right place for your foot to work the way it should. When all of the bones align and properly function together, we are able to move as intended.

Joints: Your feet have 33 joints. These are the places where your bones meet, and they allow your foot to bend and flex. The joints work with your muscles and tendons to give you a range of motion. These joints are lubricated with fluids in our bodies that help facilitate seamless motion.

Muscles, Tendons, and Ligaments: There are over 100 muscles, tendons, and ligaments in each foot. Muscles help you move your foot and toes. Tendons connect your muscles to your bones. Ligaments connect your bones to each other and keep your joints stable. When we exercise, these muscles, tendons, and ligaments are worked, allowing them to get stronger.

All of these parts work together so you can walk, run, jump, and do all sorts of activities. Taking care of your feet is really important because they play such a big role in your everyday life. If one part of your foot is not working right, it can cause pain and make it hard to move around. And at the center of it all lies the arch, a curved structure that helps your foot:

• Absorb impact when you walk or run
• Maintain balance
• Support your body weight
• Push off when you take a step

There are three main types of arches in the foot:

• Medial arch (the main arch along the inside of your foot)
• Lateral arch (on the outer edge)
• Transverse arch (across the middle of the foot)

In a normal foot, the medial arch lifts slightly off the ground when standing. But in people with flat feet, that arch either never develops (in childhood) or collapses over time, causing the entire foot to rest flat on the floor.

What are Flat Feet?

Flat feet mean your arches are lower than normal. When you stand, your whole foot touches the ground. Often, flat feet don’t cause problems. But sometimes, they can lead to pain in your feet, Achilles’ tendon, knees, hips, or back because your foot isn’t supporting you well. Flat feet can be present at birth, or they can emerge later from aging, injuries, arthritis, nerve damage, being overweight, or pregnancy.

There are two major types:

• Flexible flat feet: The arch is visible when sitting or lying down but disappears when standing.
• Rigid flat feet: The arch is always absent, no matter your position.

Flat feet can be caused by:

• Genetics (you were born with them)
• Weak foot muscles or tendons
• Aging
• Injury (such as a torn tendon)
• Obesity (extra weight stresses the arches)
• Arthritis or other inflammatory diseases
• Diabetes or nerve conditions

Some children are born with flat feet and outgrow them. Others keep them into adulthood. Adults, especially those over 40, may develop adult-acquired flatfeet due to wear and tear.

What Are the Symptoms of Flat Feet?

Not everyone with flat feet has symptoms. But when symptoms do appear, they may include:

• Pain or aching in the arches or heels
• Swelling around the inner ankle
• Tired or heavy legs, especially after standing or walking
• Foot stiffness
• Back, knee, or hip pain caused by poor posture
• Sore spots from shoes that don’t fit right
• Difficulty standing on tiptoe

You may also notice that your shoes wear down unevenly, especially on the inside edge of the heel. That’s a sign your feet may be overpronating (rolling inward too much).

How Flat Feet Are Diagnosed

A foot and ankle doctor (podiatrist) can diagnose flat feet by doing a simple physical exam:

• Observing how you stand and walk
• Checking the flexibility of your foot and ankle
• Looking at the shape of the foot

To understand the cause or extent of the problem, your doctor may also order:

• X-rays (to look at bones)
• MRI or CT scans (to view tendons and soft tissues)
• Ultrasound (if a torn tendon is suspected)

Non-Surgical Treatments: The First Step

Most people with flat feet do not need surgery. Many simple treatments can reduce pain and prevent the condition from getting worse.

A. Supportive Shoes

Wearing the right shoes is key. Look for:

• Good arch support
• Strong heel support
• Cushioning in the sole

Avoid shoes that are flat, flimsy, or too tight.

B. Orthotic Insoles

Custom-made or over-the-counter arch supports (orthotics) can improve foot alignment and reduce pain. These slide into your shoes and help distribute pressure more evenly.

C. Stretching and Strengthening Exercises

Foot and ankle exercises help make your muscles stronger and more flexible.

Try these daily:

• Calf stretches: Stand against a wall and stretch your back leg.
• Heel raises: Stand on your toes, then lower down slowly.
• Towel curls: Pick up a towel with your toes while seated.
• Arch lifts: Try to lift the arch of your foot without moving your heel or toes.

D. Weight Loss

If you are overweight, even a small weight loss can reduce pressure on your arches and improve symptoms.

E. Anti-Inflammatory Care

For swelling or pain:

• Use ice packs for 15-20 minutes
• Take NSAIDs (like ibuprofen) if recommended by a doctor

F. Physical Therapy

A physical therapist can teach you posture and movement techniques to reduce stress on your feet and legs.

Surgical Treatments

Surgery is only needed if:

• The pain is severe
• Your foot is stiff or deformed
• Non-surgical treatments have not worked

Common surgeries include:

• Tendon repair: Fixing or replacing a torn tendon (usually the posterior tibial tendon)
• Osteotomy: Cutting and reshaping bones to improve foot alignment
• Fusion: Fusing bones together to create a more stable structure
• Implants: Placing small devices to rebuild the arch

Recovery time varies but usually includes weeks of rest, a cast or boot, and physical therapy afterward.

Tips for Taking Care of Your Feet Every Day

Whether or not you have flat feet, these tips will help you stay active and pain-free:

Wear the Right Shoes

Avoid cheap flip-flops or worn-out sneakers. Rotate between supportive shoes and replace them regularly.

Ice and Massage

Use an ice pack on sore feet or roll a frozen water bottle under your foot to reduce pain and swelling.

Stretch Often

Stretch your calves, Achilles tendon, and the bottom of your feet. Even five minutes a day can make a big difference.

Go Barefoot (Sometimes)

Walking barefoot on soft surfaces like sand or grass can strengthen foot muscles. But don’t overdo it on hard floors.

Inspect Your Feet

Look for swelling, bruises, or changes in shape. This is especially important for people with diabetes or nerve problems.

Keep Your Posture in Check

Flat feet affect how you stand and walk. Stand tall with your shoulders back and knees aligned.

Flat feet are fairly common and often not a big deal. But if they start hurting, that pain can spread up your body to your ankles, knees, hips, and back. It’s about how your feet work, not just how they look. The upside is you don’t have to live with the pain. You can handle or avoid issues from flat feet with good shoes, easy exercises, and taking care of your feet daily. If that is not enough, a foot and ankle doctor can offer custom supports or surgery if needed.

Our goal at the Orthopedic and Sports Medicine Institute (OSMI) is to provide our patients with quality, cutting-edge orthopedic treatments, both surgical and non-surgical. If you have questions about flat feet, have pain, or are looking for a foot and ankle doctor (podiatrist), please submit an online appointment request or contact our office. We have clinic locations in Fort Worth, Mansfield, and Decatur.