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Flat Feet


Flat Feet

Concerns about flat feet are a very

common reason for a consultation with

a GP. A normal foot has a longitudinal

arch on the inner side of the foot. A

person with a flat foot has little or no

arch, the heel tilts outwards (valgus)

and the forefoot may rotate outwards

(abduction) when they stand or walk.

Many people will never have any

problems caused by their flat feet,

but if a patient starts to experience

discomfort they should be investigated


There are various conditions that can

cause flat feet, some are congenital,

others acquired. The most common

pathology linked to the development

of flat feet is a dysfunction of the tibialis

posterior tendon.

This tendon runs behind the medial

malleolus and is essential for the

ankle/foot alignment. Pain behind the

postero-medial aspect of the ankle

associated with a flat foot is always a

strong indication of a tibialis posterior

tendon dysfunction.

There is a spectrum of problems

caused by flat feet, ranging from tendon

inflammation through to irreversible

tendon and joint damage with increasing

pain and flat foot deformity.

If detected and treated at an early

stage, conservative treatment including

physiotherapy, insoles and brace with

relative rest may lead to a full recovery.

At a later stage, one has to consider a

surgical procedure including osteotomies

and a tendon transfer. Thereby, one can

still achieve a full recovery and good

function. At the final stage, one has to

fuse joints to realign the foot and

eliminate the pain.

In order to prevent this happening and

to make sure that the correct treatment

is initiated at the right time, all patients

with flat feet and discomfort should be

seen by a foot and ankle specialist.

Flat Feet


When Should a Patient be

Referred to a Foot Specialist?

Martin Klinke

Consultant Orthopaedic Surgeon

T: 020 7403 4162


[email protected]