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
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
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.
When Should a Patient be
Referred to a Foot Specialist?
Consultant Orthopaedic Surgeon
T: 020 7403 4162