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Flat Feet – Causes, Prevention, and Treatment

by Dr. Stephen Gangemi on March 21, 2012

Flat feet, also known as “fallen arches” are often viewed as problematic simply because they look abnormal – the main arch of the foot, the medial longitudinal arch, has collapsed. Though flat feet are by no means normal, they are often the result of some other underlying condition or weakness rather than a problem with the actual arch itself that has collapsed. Conventional treatment involving foot support either via supportive footwear, orthotics, or some other bracing system is usually more disadvantageous than beneficial and surgery is rarely the answer.

Different Types of Flat Feet

A normal foot has an apparent arch while non-weigh bearing (sitting, lying) and also when they are weight bearing (standing, walking, running). There are two types of flat feet, rigid flat feet (RFF) and flexible flat feet (FFF).

An individual with RFF has no arch at any time – weigh or non-weight bearing. RFF is usually caused by some underlying pathology. A condition called tarsal coalition is the most common reason for RFF and occurs when two or more of the seven tarsal (foot) bones fuse together. Trauma, infection, and neuromuscular and autoimmune disorders (such as Rheumatoid Arthritis) can also result in RFF.

An individual with an arch non-weight bearing which fatigues or collapses when they stand or the foot is stressed is said to have FFF. FFF is most often due to ligament laxity (the ligaments connecting the bones together have weakened) or due to muscle or tendon weakness. The tibialis posterior muscle has a major impact on the medial longitudinal arch as it provides much of its support. Therefore, a problem with this muscle can result in FFF as well as other problems associated with tibialis posterior dysfunction – shin splints, plantar fasciitis, and injuries associated with overpronation.

Development of a Normal Foot and Gait

Flat feet are normal in a toddler; as they get older the tendons in the foot strengthen and tighten to form the medial longitudinal arch, often by the age of three to six. Some never fully develop this arch in the foot, most often due to poor footwear, so they develop FFF. A childhood disease or injury could result in RFF.

A natural gait then develops in a child once they being to walk, and then run. If the child is left to move barefoot or in moccasin-type unsupportive footwear their gait will not be disrupted by external means. When they walk they will quietly land and roll off their foot and when they run they will naturally land mid or forefoot, efficiently dispersing shock and generating power, strength, and balance.

A child who moves with modern-day shoes or braces (orthotics) will always alter their gait abnormally. It is very awkward for them and their proprioception (body position) and kinesthetic sense (nervous system response to “feeling” the ground) are hindered. Ligament laxity and tibialis posterior muscle weakness can and does often occur resulting in FFF.

As you can see, optimum foot development occurs barefoot.

Shoes and Orthotics Negatively Affect the Foot

I always chuckle when I hear the terms “corrective shoes” or “corrective, functional orthotics”. These are misnomers – they provide support of the dysfunction, never any correction. I won’t discuss the major pitfalls with either as there is plenty of information on the SockDoc site regarding the negatives of orthotics and the benefits of barefoot and minimalist-type footwear.

There are studies and clinical evidence showing that treating FFF with orthotics doesn’t change the course of arch development. Actually, though strengthening the entire foot and lower leg is important for the health and fitness of everybody and especially a person with flat feet, the arch may not change significantly if there are anatomical changes that have occurred during development. In other words, it may be too late (the person may be too old) to see  FFF regain its weight-bearing arch. However, this should not be of concern as there is no correlation between an arch height and injury, pain, or performance.

In 2009 Pediatrics published a study of 218 kids aged 11 to 15 and found “no disadvantages in sport performance originating from flat feet”. The kids who had flat feet accomplished all 17 motor skills as well as the group with “normal” feet.

Another study of 246 US Army recruits found that trainees with low or flat arches actually had a lower risk of injury than those trainees with high arches during their 12-week infantry training.

So although one would not want to just ignore their FFF, or especially their child’s FFF, it shouldn’t be any cause for alarm, and especially no reason to wear supportive shoes or an orthotic – either will simply make the problem worse. Orthotics and arch supports that are used to treat flat feet and fallen arches don’t support the arch of the foot where it actually needs to be supported. To properly support any arch, from a bridge over water to the arch of the foot, either end of the open space should be supported. In the case of the foot, the heel and the forefoot should be supported, not the space in-between the ends of the arch. These devices only promote more weakness and dysfunction and DO NOT change the course of arch development.

Natural Prevention and Treatment of Flat Feet

Though most FFF are asymptomatic (no pain or discomfort), they should still be addressed as it is not normal to have flat feet. Obviously it is always ideal to prevent a problem rather than treat it after it occurs, especially if FFF is being treated post-foot development. As mentioned earlier, barefoot is the best way to prevent FFF and a host of other foot and gait imbalances. To truly strengthen the entire foot and all the arches, it’s important to position the foot correctly at all times so when wearing something on the feet, footwear should be flat, firm, and flexible. This means that the shoe should not have a significant, or any, heel to toe drop, there should be little to no cushion or padding in the sole, and the shoe should not be rigid anywhere – it should bend throughout the shoe and in any direction. The shoe should also be wide at the toe box allowing the toes to naturally splay apart.

Standing and walking barefoot are two easy ways to start treating flat feet naturally. Balancing on one leg and light jumping while barefoot will further progress the normal development of the foot; and finally running while barefoot is the ultimate way to naturally and most effectively strengthen the muscles, tendons, and ligaments of the lower leg and foot. Of course a child running barefoot is much less likely to have FFF than a shod child.

Sometimes other interventions and therapies are needed for flat feet. In the case of RFF, which is much less common than FFF, treating the cause of the problem is recommended. If the RFF is causing problems (such as pain) then in some cases, depending on the individual, surgery or a supportive orthotic may be beneficial. Trigger point work and other therapies can also be very beneficial for RFF and especially FFF to help in the rehabilitation of the supporting structures of the foot. The tibialis posterior muscle is the muscle I most often have to treat for flat feet due its importance with arch support. Check out the Sock Doc video on Plantar Fasciitis for more information on how to find and treat trigger points for this muscle, as well as more information as to why the tibialis posterior can fatigue aside from improper footwear or gait mechanics.

I'm a board certified chiropractic physician and clinical nutritionist with a passion for true natural health care. I implement dietary & nutritional therapies, exercise & movement practices, and lifestyle changes along with manual therapy techniques to help the body heal and prevent illness and injuries.

From → Health Concerns


Leave a comment
  1. hi,
    Nice article. But Can you tell me is there craniosacral therapy is useful or not?
    Thank you

    • Sure I think therapies that address the nervous system have a powerful impact on the entire body.

  2. Renee permalink

    Do you feel that epsom salt bath (100 per cent natural mineral) would help with plantar fascitis? Although you did mention it really isn’t an inflammation issue there, I felt crippled walking out of work last night, holding on to any object in sight on my way through the parking lot to my car after being on my feet 8 hours. I have PF and despite trigger points, 0 percent shoes and staying away from aleve and advil, my feet were screaming. How do you feel about “yoga toes”, a neat little gadget that separates the toes while you elevate them and read sock – doc blogs. ; )

    • I think Epsom salt baths are fine but I doubt they will help PF. If you haven’t watched the video over at the sock-doc site head over there and see that. I mention a product called Correct Toes – that’s what I use. I think they’re much more effective than yoga toes.

      • Tahir permalink

        i am 25 years old and i want to join army but have a flat foot problam.please tell me who we can solve this problem?

  3. Catherine Mallorie permalink

    A very exciting and empowering article Dr Gangemi. Do you know of people in the UK who are thinking along the same lines as you that I could contact to work with my FFF? Thank you and all the best, CM

  4. kadijah permalink

    Hi My daughter is 10yrs old. she has bee complaining of foot pain and her xray show an accessory navicular bone. She was practically raised barefeet. She only started wearing shoes while she is in school and they are the five finger shoes by Vibram. AKA barefoot shoes. She still has pain and her posture and gait seems to be compromised. We were considering the Hyprocure treatment or orthotics but after reading your article, Im not sure what to do.

    • Never hurts to get a second opinion. You can send me an email and I’ll let you know if I know anyone in your area. I’ve never seen someone who had the HyPoCure done, so I can’t comment based upon experience. But I have seen many people who have fused bones in their feet where surgery failed them and others who were told surgery was the only cure and it wasn’t the case.

    • karen permalink

      hi i have a sore ankle and i was diagnosed as having fallen arches i dont know what to do i am in the process of buying ortho heels by the physio i am interested in your article about barefeet could this help my problem and do i wear a vivo barefoot shoe for a walk i am not a runner just an average person who likes exercise i am petrified of having flat feet and the arches completely collapsing i can stand but cannot stride as my arch will generate pain due to a ligament pulling so i walk general not hurried could this be cured by walking barefoot in time

      • Orthotics cannot correct fallen arches, that’s impossible. More information on the sock-doc site too.

  5. Ed Bowman permalink

    Doc, kudos to you for taking the time to give good, solid advice to all of these people in pain..I am 61 years old and have been diagnosed with Tibialis Posteria Dysfunction Syndrome. I work 6 days a week and do most of my walking on concrete. I have put Dr. Scholls Foot Pads with arch support in all of my shoes and sneakers. I have been wearing an aircast for arch and ankle support for about 2 months now but the pain is not getting any better. I am 6’3″ and weigh 220 lbs. my wife and I are very active, we play volley ball, snow ski, Jet Ski and ride a Harley when time allows. I play golf several times a month, and altho I hate taking a cart, I need a cart to finish my round because I can’t walk 18 holes, 9 holes maybe, but no way can I walk 18 holes. The pain started at the base of my great toe then migrated to my arch and has settled just above my right ankle above my arch. Should I be doing the toe curls? Should I be doing more? I want to be able to play ball with the grand kids again, and I want to walk 18 holes again.

  6. Sharon permalink

    Do you have a video of someone lightly jumping on one foot for strengthening fallen arches?

  7. nobriga permalink

    hi sorry but i started to read this then got confused with what you were saying. so basically i have one foot that’s flat, the other has a low arch. i can’t even stand with my feet flat on the ground for longer than a few minutes without pain and i tried orthothics from my doctor and my feet still hurt. is there anything i can do to eliminate the pain from my feet? this pain affects my lower back as well and it’s a serious problem seeing as how i want to enlist into the army. i’m able to walk and run for hours and my back is fine without a little discomfort in my feet but my legs and knees are fine it’s only when i keep my feet planted in the same spot do they hurt a lot. so again, is there anything i can do to remedy it? thanks

    • Check out the info on the sock-doc site about how to help strengthen your feet. Also I’d recommend you look for a doc or therapist (chiropractor, PT, rolfer, or holistically-minded podiatrist) to help you figure out why your feet hurt. Don’t assume though that it is from the flat feet. Though it may be, often the foot has lost the arch from the muscle weaknesses in the lower leg and foot and those can be corrected – but the arch may not come back, though the pain can be resolved. Orthotics, of course, will never actually correct this.

  8. John D permalink

    This is a very informative arrticle Dr Gangemi!

    I would like to know if you would still recommend low heel-to-toe drop and minimal cushioning shoes for RFF?

  9. John D permalink

    Rigid Flat Feet.

    Most people are now recommending minimalist shoes for flat feet to get the muscles stronger. I’m assuming most of them have Flexible Flat Feet in contrast with my case where even if I tiptoe, no arch would be seen.

    I’m just curious if I can get my foot muscles strengthened even if the bones in it act it’s “splinting” my foot muscles.

    • This one is hard for me to comment on because I’ve only seen a few people with Rigid FF, where I’ve seen a lot with FFF.

      But I’d say that in both cases, definitely in FFF, you can strengthen the foot muscles by going barefoot and in min-type shoes, but in a rigid FF you’re not going to develop an arch.

  10. Matt permalink

    Thank you for opening my eyes to a new approach. For four years I’ve been unsuccessfully trying to treat shin splints with custom orthotics and supportive running shoes and doing everything else experts recommend. I’ve been told the right orthotic will solve the problem. After four years I’m despairing, but maybe I’ve just been following the wrong school of thought. Do you know how I can find help treating chronic shin splints from a barefoot perspective?

    • Matt – plenty of info on barefoot and shinsplints over on my Sock-Doc site. My Shin Splint Video there too.

  11. Cecil Wayman permalink

    I’m 66 and have worn orthotics for several years for what a podiatrist described as a collapsed arch (left foot.) He proposed a surgery involving swinging my heel back in and screwing it in place with a bolt, shortening the stretched tendons, and putting me in a cast for 6 weeks. What complicates things is that I also have compromised veins from a bout with DVT, and I doubt that surgery would be as uncomplicated as he seems to think. Unfortunately, my pain is pretty strong, and it limits the amount to which I can walk. I’m extremely frustrated. Do the suggestions on this site apply to my condition, or am I just stuck with the pain?

    • Check out the articles on the Sock-Doc site.

      • Cecil Wayman permalink

        Actually, I had already read the articles you’re suggesting. My concern is that while I have had flat feet since birth, my left arch is observably collapsed even further, the heel swings to the outside, and nothing that I have read on your website or elsewhere leads me to believe that this condition is correctable by anything short of surgery… yet, as I previously explained, surgery poses way too many risks for me. So are you suggesting that being barefoot and/or wearing appropriate shoes can at least make me pain free? Is there any evidence that doing so can in any way correct the condition I’m reporting? Thank you.

        • I’m suggesting that going barefoot and doing the exercises I show in the Foot Strength Video are a good start to improve foot health and strength. Since I don’t know you I don’t know how far you’ll get with just that. Ideally you’d want to see a doc who knows how to assess and treat your condition.

  12. Trudy permalink

    Great article! I started running longer distances last year. I was wearing Nike Free shoes but had an assessment done by a podiatrist and was told I have the worst feet on the scale. I have FFF and toe in with my left foot. I got the orthotics and ran with them for much of last year. I had chronic toe pain and they felt terrible!. I stopped wearing them in the fall and after completing a half marathon 2 weeks ago in stability shoes without my orthotics my feet are a mess (severe pain on the outsides of both feet and blisters). I am told that I need to wear my orthotics or get motion control shoes. My feet were never sore before wearing orthotics. I feel most comfortable in flat shoes. I ordered a pair of zero drop shoes today. I don’t want orthotics. Do you have any suggestions for me?

    • I’d say you’re already on the right track. Check out the Sock-Doc articles though for a lot more on orthotics and what healthy feet really mean.

  13. Nadine irving permalink

    I am having really bad pain in the bottom of my foot where my arch is could I have fallen arches I have always had a problem with my left leg due to a large strawberry birth mark that runs full length. Also with problems with my hips thanks.

  14. rwan permalink

    hey !
    iam 15 years old girl and i have flat feet but it doesn’t hurt me at all and i tried the shoes which support the arch and now i wear insoles but nothing changed is there any thing i can do ? because it really makes me uncomfortable i can’t wear any shoes i like and it sucks

    • Well as the article states I would never recommend wearing arch supports of any kind for flat feet. All those will do is weaken your feet especially as you’re growing.

  15. How does idiopathic toe walking fit into the picture? Both my children have toe walked since they were toddlers and are on their toes the second they are barefoot, the youngest (6yrs) even in shoes. I have been told they have extremely flexible/hypermobile, flat feet, but that toe walking will shorten their tendons. The oldest (12yrs) is ‘duck-footed’ with turned out feet and finds it nearly impossible to run. I’ve been brushed off by more physicians than I can count about their issues.

    • For kids it’s best to find a doc (usually a chiropractor or naturally-minded podiatrist) who can help you figure this out as well as help with your kids’ rehab. The toe walking is often related to sensory disorders; I’ve seen plenty of kids who stopped toe walking once their diet was changed and certain nutrients were taken.

  16. Vipin permalink

    Hi Doctor. Wonderful article. My name is Vipin and I am 26 years old. I have FFF on my right feet and it hurts my knee as well as my back a lot. I try to straighten (position) it and walk but it tends to hurt a lot more. Now I have come down with Gaut and going through treatment. Both the issues together is crippling me down. I used to be an athlete and it hurts on an emotional level as well. Do you have any advice for me?
    I really appreciate how you find time to reply to everyone.


  17. Victoria permalink

    Hi Doctor,

    I just stumbled across this site while doing research about orthotics. I have a recently diagnosed accessory navicular bone on both of my feet. My podiatrist recommended plastic orthotics, which I now use in both of my shoes. Without them, after extended time on my feet (hiking, walking, even just standing), my arches start to hurt a lot. The only way I can describe the pain is that it makes me want to step on ledges and rocks to kind of massage my arch (if that makes any sense). After reading this article, I am a bit wary of utilizing my orthotics. Do you think they can cause me harm in the long run? Or should I continue to use them in order to keep my symptoms in check? Thanks!

  18. Eric Nelson permalink

    Hey, I’m 18 I have flat feet, is it possible to get my arches built up so I have normal support? I don’t believe in impossible when it comes to anything related to what the body can do when being taken care of correctly.

  19. Drew Cummings permalink

    Hi Doc,
    I have a friend who developed flat feet apparently during pregnancy (approx 6 years ago), sometime following she was prescribed orthodics and like most believes what she is told by ‘experts’. She runs regularly and is aiming at a marathon this year so while it doesn’t hamper her, she is still convinced she needs them to run. I have tried to explain that they are not doing anything to help and have even gotten her out onto a park to run a few km’s barefoot (which she did easily!).
    Do you have any suggestions for a path forward away from orthodics?

  20. Muhammad permalink

    Hi, I’ve had problems with my flat feet for a couple of years, and I’ve had orthopedic insoles for the past 5 years. The insoles definitely took away the pain when I am walking, but when I play basketball or any sport, sometimes the pain is so severe in my arches, I can’t even walk after. I’ve even had to be carried from the car to a couch in my house because I could not put any weight on my feet. Is there anything else I can do to prevent or even lower the pain while playing sports. I love playing but within 30mins my arches and lower feet are aching and burning.

  21. kamran permalink

    Dear Sir,
    i have a Problem in both of my feet for the past 5 Years and i ihave been going to different doctors BUT no results……Symptoms are as follows:

    1. when i walk up in the morning i have too much pain in my Heel, specially real side of the heal.
    2. i get tired very fast
    3. by the end of the day i have no energy left in me.

    looking forward for your advise.


  22. Tonisha permalink

    I think i have FFF! I will be getting surgery on my ankles to create somewhat of an arch so my question is how long will the recovery be

  23. Tonisha permalink

    When i walk the middle of my feet feel like they are splitting and hurt really bad. I have small feet so when i buy my shoes i have to shop in the kids section so i don’t have a big variety and support for my ankles and feet.

  24. I’m young and have flat feet and I don’t know if it is serious, I also play soccer. I went to a foot doctor and he wrapped my feet up in tape, it was kept on for about 6 weeks. After that it still did not feel better and I have done that process twice. Can anything be done to make an arch in my foot? Also the outside of my foot a bone is slightly sticking out with minor bruising on the inside and outside of my feet, please help!

  25. I have flexible flat feet, I didn’t wear corrective footwear as a child, and wore shoes in a normal way (at school etc). I have always had flat feet, they’ve never worsened or improved. My father also has flat feet. This has lead me to the conclusion that it is hereditary to an extent.

    I really disagree with you when it comes to orthotics, I suffer from ankle and back pain as a result of my lack of arches and orthotics really help with this.

    I have been told in the past that it is the fault of my childhood footwear, and this is just not true, and in fact slightly irritating. As a sufferer of flat feet, orthotics help.

    • KiwiBoy permalink

      Totally agree. I grew up in a country (New Zealand) where we often go barefoot. In fact, most of my childhood was barefoot, and at school I usually wore roman sandals or shoes without supports, even through high school. I have FFF in the terminology here, and get knee discomfort and pain that can leave me bedridden. It gets WORSE from walking barefoot or without support, and BETTER when I consistently wear supportive footwear. From all these websites promoting barefoot walking as a panacea, where is the evidence? Where are the testimonials of people who have gone from collapsed arches to “normal” arches? Btw, I LOVE being barefoot. My friends through my 20s used to tease me because I hardly wore shoes. Both parents grew up hardly wearing shoes and also have collapsed arches.

  26. Jessica permalink

    Hi.I am 26 year old female. I’ve always suffered from a flexible foot which made me pronate. I have an arch yet falls flat upon stepping down.I had navicular accessory and misaligned heels.last year I had the kidner procedure and hyprocure done. It was a last resort thing.I had gone through a few pairs of orthotics since I was 18,I couldn’t walk barefoot and my feet constantly hurt, especially where the extra bone was and any area around it. They’re not a hundred percent better though I’d say fifty percent. I don’t expect after 25 years of having this issue for one year to Cure it. My heels still turn out but no where as bad as before. My feet hurt while being on them all day as my job calls for it. I went to road runner and bought new stability shoes and foot balance insoles but really worried if o start wearing insoles again my feet will get worse. They feel good under get but not sure what to do. The tighter and more snug the site

  27. Frank Adams permalink

    Hello: I have adult acquired flatfeet that has developed into PTTD or Posterior Tibial Tendinitis. The pain is very severe where the tendon goes around the back of the ankle. Inserts and support shoes do relieve pain but not the problem. I have started to do light running with shoes but focusing on ball of foot strike and proper technique but the pain near the ankle is devastating. I am a backpacker and want to develop into a trail runner without heavy support shoes. What do you suggest.

    but the pain is not in the arch but the Peroneus L

  28. Anna permalink

    Hi! My brother has RFF and he has worn heavily arched orthotics his entire life. He was born with flat feet which were inherited from my grandmother. She currently wears braces on both her feet and can barely walk.
    The situation is that my brother and my mom (FFF) have flat feet. I have low arches and am currently trying to go barefoot and it is helping so much with my foot problems! Because of this, I’ve tried to convince my mom and brother to go barefoot, but they refuse to believe that it could help. Are there any doctor-written articles concerning this condition, especially with RFF?
    I really want my brother’s feet to heal up, but I havent found any articles to support this and both he and my mom refuse to believe anything not written by a doctor.

  29. PIYUSH permalink

    Sir, I have flat foot. Can upls tell how to cure it as I want to go for army .
    some natural and easy methods pls

  30. Brandy permalink

    What do you think are the best brand of sneakers out there for flat feet. I have tried different shoe brands. Adidas, Sketchers, Payless and i find that none of them support my feet when i am standing or walking all day at work. I was born with my feet pigeon toed in and always had foot problems, when i was 13 i had corrective surgery and the doctor placed a plastic piece inside my ankle because he said a bone was missing when i was born. My left foot was done and i never have any problems with that foot at all. I had my second surgery done when i was 19 and that took longer to heal, i was suppose to get physical therapy with that foot but was unable to go due to not having any transportation to get there. Since having that surgery on my right ankle, i still have pain in it when i walk a lot through out the day or I’m standing for long periods of time. The doctor told me i need to have orthotics but i couldn’t afford them at the time. Since you say orthotics are bad for your feet. What do you suggest i wear on my feet so i won’t have any pain in them at the end of the day

  31. Suki permalink

    Hi! I have ligament laxity, 1 cm leg discrepency and flat feet. I got orthotics but had to make many adjustments over a 3 month period. The final adjustment drastically changed the orthotics and removed the extra heel lift on my shorter leg and made the orthotics equal height. A few weeks later, I developed terrible hip pain which still has not healed after 7 months. I can barely leave my house and had to drop out of school.
    What do you suggest I do?
    Thank you so much!

  32. char permalink\&src=PE4077Chen%2813-1%29.pdf

    Per above; You must rethink the flat foot – it’s how we are designed to be: See important research above – this researcher is the Christopher Columbus of our time, discovering/concluding lifelong damage caused by arch support wear. She states prior to her year 2000 study, effects of arch supports were never truly scientifically studied. Flat feet properly distribute weight, engaging foot/ankle muscles, glutes, abs & lats properly (all contract at same time as foot forms arch to act as springboard off ground). She found on weightbearing, arch supports cause heel to rotate inward (which causes foot/ankle complex to become angular) thus improper weight distribution/malalignment.

    When not walking, thus these above systems not co-contracting upon natural arch formation as heel leaves ground, a permanently arched foot causes permanent, mounting body-wide tension (even while asleep!), thus poor posture & joint problems.

    Purpose of foot arch (Dr. William Rossi): To help make foot rigid as heel leaves ground to help with push-off. By the time foot returns to ground, it is completely flat.

    Below article, same researcher: Found angular joints impede blood flow, as found in those with peripheral arterial disease

    J Biomech. 2008 Aug 7;41 (11):2506-14 18586253 Cit:7

  33. Amy carol permalink

    Hi , I have a 10 yr old son who has fallen arches . He loves to play sports but it is so hard for him to run . I was using orthotics but after reading what was written I may not use them .
    His ankles bother him after too much running skatting what ever the activity. What can I do to strengthen or could surgery be done to help this. I do not want him to give up on sports but it is painful to his body.
    He was also born with low muscle tone and we have always done pt.
    Any suggestions to head into any direction
    Thank you Amy

    • Check out the foot strengthening video I have on the Sock Doc site. That’s a good start though you will most likely also want to find a naturally-minded practitioner to help him out.

  34. Tea Schiano permalink

    I WAS able to restore my fallen arches which I had all my life – I am 60 and they were flat with inward pronation. I first starting walking on the outside of my foot holding my arches up as if I had them especially effective when barefoot. Then I wore some high hard orthotics I had made for me and I added an over the counter arch support on top of the one that was lower on the orthotic then the other. Now after some time a year or so I now for the first time in my life have normal arches! I first noticed it at the swimming pool when I saw my footprints. I couldn’t believe they were mine! They looked like those of an Olympic athlete. Before they were always flat as pancakes and my gait was odd and uncomfortable rolling in. Now I have a springy athletic step, for the first time in my life! I no longer feel like I have to hide my feet when wearing sandals! You may say this is the wrong approach and will create problems, but it did not, it is a couple of years later. I rarely wear the supports, usually an over the counter gel full pad, but sometimes not even that. I love to walk barefoot because I didn’t ever know how good it would feel to have normal arches, that is any arches at all.

  35. Annie permalink

    Hello ….. I have “medial patellar tilt” in both of my knees. My patella has been tilted. Because of this I have fallen arches in my feet.

    I do knee strengthning exercises but…. ‘am thinking if my patella cartilage rubs against the bone.

    Dr., do u think I should wear orthotics – silicone medial arch support.

  36. namelesshere permalink

    I use These I idk what they are technically but an in sole of sort although they have an insert in teh middle so as to STEP UP the level of therapy or what not not sure as I have lost the packaging … and they were made by Joann and hale from body Break .. they really helped me out i no longer have arch pain but i have what’s known or my doctor told em i have in my left foot a fallen arch.. it’s more or less in the ball area or and just above that it is a bit more concave than the other foot.

  37. furqan permalink

    sir i am 17 yrs of age .
    i have flat feet. my calcaneal foot angles are 17 and 16. can you tell me any way through which i can make these angle till 18. plz reply soon

  38. Graigthomas permalink

    I am 17 and I have flat feet. I run, walk, play sports just like everyone else with normal feet. My feet just do not bother me. Could that still cause bad long term effects

  39. Eli permalink

    I had an inversion sprain and the vertical ligament between the ankle bone and the sole was very painful for 18 months. It just would not heal.

    Then a physio diagnosed me with flat feet and gave me orthotics. Within 2 days all the pain I’d had for 18 months was gone. However after about a month of wearing the orthotics I developed sacroiliac joint dysfunction in my lower back which never went away after 15 years. So orthotics can help temporarily in my experience.

    • Well of course they can “help” – but now you have SI pain. So that’s “robbing Peter to pay Paul”.

  40. Rich Gibbons permalink

    Hey Doc love your website and articles. My 15yo son plays soccer and had a bad ankle sprain about a year ago. After Doctor’s and physical therapy he went back to playing but all told me he needed orthotics. I bought inserts (Superfeet) for all his shoes and soccer cleats. He used to be the fastest kid around and now he is just average speed. It seems the orthotics have changed the way he runs and has slowed him down. His stride frequency is way down when he runs. Could the orthotics be the cause of this? I am slowly weaning him off the orthotics and am convinced they have been the cause of his much reduced speed. Am I right?

    • Yeah of course they can do that. Check out a lot more info on this on Sock Doc. No growing kid should be wearing orthotics!! Maybe rare exception but I’d say very rare.

  41. Jazz permalink

    sir … i have fft … plz tll sme exercises whichh hlps in developing arches …

  42. Elle permalink

    After weeks of PT and painful Graston, I had improvement of my bilateral PTT tendinitis. My PT told me to avoid orthotics, which I did, since the PowerStep insert supplied by the podiatrist made my pain worse-i actually walked better barefoot. My balance improved, so did my ankle dorsifexion and I could walk upstairs normally. After working two difficult shifts at work I regressed. My right foot and ankle screams with pain and my right foot kicks out behind me when I walk upstairs. I have been assigned to work those difficult shifts and I am terrified I will be crippled by them if I go minimalist. In an effort to get advice I saw the podiatrist yesterday, who added more padding to the Powerstep which made it more painful. He avoided giving me a diagnosis and he did not ask me to stand on my toes, which I can not do. He told me to stop exercising, to buy running shoes and custom orthotics. I guess I need a new podiatrist.

    I have ordered Correct Toes. And I am going to try out Super Feet insoles today to see if they help my tendons rest when I am forced to be on my feet during those heavy shifts. I am considering buying braces to use at work. But I am not sure which one, since there are several on Amazon.

    I have read that strengthening hip muscles can help with PTT.

    My goal is not to be permanently disabled by this and I need advice to help accomplish this goal. Thank you.

  43. Jeff permalink

    So, you’re saying for an adult that has fallen arches the better option (for a runner) is to either run bare foot, or with one of those shoes that are supposed to mimic bare feet?

  44. Jesus permalink

    Is there anything i cand do to make my wide foot smaller? I really hate shopping for shoes and i cant wear them because my foots to fat :( ? ~MALE

  45. Neesh permalink

    Hello thank you for the useful information. I’m 21 and have had arthritis from the age of 10 and I have flat feet no arches at all. When I walk or run my feet are fine however standing more or less in the same place for 9 hours has a realy bad impact on my feet especially where one leg is longer than the other. This all affects my lower back and knees.. The pain is literally unbearable. Even right now I cannot rotate my left foot or put any weight on it. I’m looking for more comfortable shoes that I could wear.

    • It’s not about the shoes but about your feet…check out the sock-doc site for more info.

  46. A really enlightening article. My daughter, just turned two has overpronated ankles. I was told she has mild hyper mobility. It does not seem to cause her any problems but I worry all the time about choosing “the right” footwear for her.
    She has had 2 pairs of quite rigid boots that come up to her ankles but having read about the barefoot argument I’ve now purchased a pair of vivo barefoot pally shoes for her. I intend to leave her barefoot as much as possible as the weather gets warmer. Do you think these shoes are a good choice for her problem. I think she fits into the Fff category.
    Also, is it ok to let her walk around in her socks indoors when it’s colder?
    Thanks for all your advice.

    • Yes I think that’s the way to go and I’m all for socks when it’s cold (inside or out!).

  47. Juhi Nitin permalink

    I have very flat feet so when I stand my feet curve outwards where my arch is supposed to be. This causes many problems for me considering I’m in a sport. My posture has worsened and I got shin splints (stress fracture) on the insides of my shins. I went to consult a foot doctor and he told me I have insanely flat feet with a special name that I can’t recall. But he told me that my feet would always cause problems for my ankles, shins, and knees if I don’t wear support such as orthotics. I have began wearing the orthotics and already the pain has been minimized.

  48. Mac permalink

    Doc, it was a wonderful explanation about the problem,
    basically I have got flexible flat feet. As a result my calf and the part below knee seems to be curving out abnormally and knee cap is misplaced. I noticed it few months back. Tried few doctors nothing worked. What should I do Sir?
    I guess its pronation type of, treatment for it ?
    thanks :-)

  49. pj jackson permalink

    If the right arch in my foot goes flat and the other foot arch is fine could this have an effect on my body? Is it possible to gain my arch back? What steps to i take into solving the problem?

    • Check out the Sock-Doc site. Even if you can’t gain the arch back you can still regain strength and stability in the foot.

  50. Mahesh permalink

    I have flat foot and extra bone on right foot (accessory navucular bone). I feel the extra bone on Left foot is still developing. I started getting severe pain in right foot about 15 months back, later it was diagnosed as accessory navucular bone problem. I was suggested to wear shoes having inbuilt support for the arch. Also doc suggested some basic physiotherapy ( repeated feet movements in hot and cold water). I ususally get the pain when I walk/work continuously. So whenevr I feel severe pain, I take rest for a while and then resume my work and I have started wearing shoes recommended by doc.
    I am in my twenties and my only concern is what will be its effects as years pass by?
    How worse the situation is going to get?
    Do I have to undergo surgery after a certain stage?
    Is there any chance that left leg also reaches same stage ?
    Is there any chance that I will get physically disabled (totally unable to walk) ?

  51. Anne Shea permalink

    I have a foot deformity in that the bones for my big toe and the one next to it have double the space between them that they should. I have wide feet because of this and have had foot pain since my 20’s. I am now in my 50’s and have Morton’s neuromas in both feet. While these issues cause me some discomfort, I manage. My 14 year old son has inherited his father’s flat feet. It seems to be congenital, since most of the relatives on that side seem to have this condition to some degree. My husband and my son seem to be the flattest. My son is an athlete and has had a propensity to roll his ankles. He also is a bit hyper-mobile (runs in my side of the family) so I thought that was the problem. Then he began experiencing severe pain on the insides of both knees, especially when he went from wearing cleats to sneakers. Our chiropractor recommended GoodFeet inserts. We got them and the knee pain was instantly better. He also has not rolled his ankles all summer, in spite of playing lots and lots of lacrosse. His foot is beginning to show an arch, which the chiropractor said would eventually happen. He said it would retrain the muscles and ligaments in the foot. I guess I don’t really know what to think about your recommendations. I grew up barefoot, except when in school, and my kids have as well. Now I find my feet hurt more when I don’t wear shoes. I wear wide width shoes with soft insoles and can stand much longer without pain. The GoodFeet inserts are expensive, but I had considered trying them myself eventually. When you talk about flat feet, you seem to think it is caused by something we did, but I can say that my first three children with a different father, did not have flat feet. The two with my current husband are both flat footed. I just wondered if your discussion is really only for people with no congenital foot defects. I would like to save the $$$ rather than buy the inserts, but I don’t know if that is an option for our family. Thanks.

  52. Romina permalink

    Hello, I have flat feet and I twisted my foot during a game in a hole that was on the field. I have iced it and iced it but neither the pain nor my bone where my arch should be is sticking out a bit. It’s been a couple of months since this and I’ve been so busy that I’ve put it off. Should I see a Podiatrist or a Orthopedist? Thank you in advance.

  53. Leah permalink

    Hi doc
    I’ve had a obsession withy arch for years. I use my fingers to push on it and can hurt but it feels nice and I feel as if I’m massaging it but the problem is once u have done it ur foot feels like it needs massaging evey miniute of the day am I weakening my arch

  54. vipin tiwari permalink

    Hi doc I need ur help for my 2yr baby .he has flat foot . I don’t understand what should I do.plz help me

  55. hey doc!!!
    your article is very satisfactory…i just wanted to know from you that i have flat feet,not like that of duck flat just little bit but i want to enhance my arches…
    is it possible?
    i applied for the armed forces and they refused me because of this.i got a X-RAY and according to that my feet curve are 16 degree,the requirements are of 18 to 20 degree atleast…can i attain this?
    please help.thanks!!

    • Not sure but plenty of videos on the sock-doc site to help you get strength and mobility back in your feet.

  56. azeem permalink

    Dear Doc..
    i am 19 year old and facing same problam …. i have not flat feet but little bit flat can you help me sir i want to join army and i was worried about it

  57. david permalink

    I think I might have that case of FFF and I am doing what you recommended. How long is it that I should be seeing some results and how can i maximize on those results?

    • Hard to say – it depends on many factors. As early as a few months, sometimes up to a year.

  58. Daniel Keltz permalink

    Hey sock doc, I hope you respond to this message.

    Anyway, I have been suffering from chronic foot pain off and on for a couple of years. I just recently had an MRI than diagnosed me as having Achilles tendonosis, retrocalcaneal bursitis and tendonosis of the posterior tibialis. Although this MRI was of my right foot, I have believe that I have a similar thing in the other foot.

    A little about my history. I began wearing minimalist shoes about 5 or so years ago. Mainly NB Minimus and Luna Sandals. At first, my feet felt great and I could not wear any sort of traditional shoe. I did a fair amount of running, mostly off road and on trails and virtually no running on concrete or asphalt, however I did do a lot of walking on those surfaces.

    While I did those activities pain free for a while, my feet now hurt almost constantly whether I am barefoot or not. I have stopped wearing minimalist shoes, because I believe that they exacerbated, if not created the condition that my feet are in. I would love to be able to be barefoot again and believe that it is the right way to be.

    At this point, I want to get out of pain, whatever remedy may help, however I do not want surgery and I do not want orthotics. I have just begun physical therapy, but I do not know what else to do. For the record, I have fairly flat feet.

    If you have any suggestions, I would be most interested.


  59. Daniel Keltz permalink

    just read the article. not sure exactly what to take away from it, other than the fact that I probably rushed into minimalist/barefoot too soon and am now suffering the consequences of it. my hope is that my feet are not permanently damaged and then i will be able to return to running and dancing again, preferably with my feet in a natural and unsupported state.

    if you have any other other advice for me, i would be greatly appreciative.

  60. Jessie permalink

    Orthotics do help. I have suffered from plantar fasciatis All of my adult life until about a week ago when I bought some orthotics from a sporting goods store. They have to be hard plastic like ones to get the effect I was looking for but once I found the right ones I felt the relief of presure come off of my heal and I could feel the tension in my lower back easing. The effects were almost instantanious. I am not 100% pain free but the pain gets better and better everyday. I disagree with this article on terms of orthotics. I highly recommend anyone who has had plantar fasciatis related pain to go spend $40 at Peak Performance and save 100 of dollars in dr. Bills and hours of time in a specialists office. They just might help with your problem.

  61. Kat permalink

    Great information and video. I don’t ever wear heels but prefer flat shoes and reading your article, I’d say I was FFF. I do not have pain upon rising, only when I was and especially when I walk in a “good/supportive” running shoe. When I wear flip flops or “Toms” shoes (very flat canvas shoe), I seem fine. I talked to a few people – chiroprators etc., they said my foot just needs to get use to the running shoes. Your barefoot advise makes more sense. I wear a supportive slipper even around the house when I guess I should be walking barefoot.

  62. suzanne wheat permalink

    I have low arches and there are no shoes in existence that I can wear comfortably. Any heel on a shoe causes my entire foot to slide into the toe.
    In vain I have searched for a flat shoe for general wear. I have even searched for a custom shoemaker online who could, at great cost, help me.
    Even the flattest shoe has a heel that comes along with a too-small toe box.
    I used to wear tennis shoes all the time. No more. Now the cheapest tennis shoes have so much stuff in them that they don’t work either.

    A couple of years ago I had orthothotics made. Unfortunately, they were clunkers made only for sports shoes and presume a flat footbed to put them in. Can anyone out there make suggestions as to where I can find shoes?
    I have worn the same Crocs for 10 years because with every step my foot adjusts to it’s “arch support” by moving back with every step. Plus, cheap plastic tends to flatten over a short period of time.

    • suzanne wheat permalink

      Barefoot would be great for me except when I am on city streets of running to the subway. I’ve found that so-called barefoot shoes still try to put a lot of supportive junk inside. If I could find barefoot shoes that have a footbed shaped like a country lane or city sidewalk, i.e., flat, my foot problems would be solved.

  63. Hi there. I was wondering if you could maybe give some insight on the issue I have. I stumbled onto your article in the hopes of gaining some knowledge to kind of reverse engineer the problem I have been struggling with for years. I have extremely high arched feet. Because of this, I bear most, if not all my weight on the outsides of my feet to protect my knees, because if I let all my toes bear weight, my whole leg internally rotates and that causes medial stress on my knee. However if I externally rotate my leg & bring my knees into correct alignment, hardly any of my toes are even touching the ground because all my weight is on the outside ridge my foot.
    On a normal day, my big toes barely take any pressure of my weight when standing. Im assuming the root of my issue stems from my feet because as soon as I externally rotate my femur into correct position, my whole foot is out of whack and not providing any stabilization whatsoever.

    So my question is… If its possible for the foot to lose its arch over time, then that tells me that the arch of the foot is mostly determined by the musculature surrounding it. Would it not also be possible to decrease the arch of the foot by releasing the tight muscles creating it in a problem such as mine??
    These are only mere assumptions. If you could give some insight it would be greatly appreciated!

  64. Sara permalink

    I have been getting into hiking in all seasons, from 5 miles to 24 in a day. My back and hips have been bothering me quite a bit, and I’ve been to an orthopedist (zero help zero diagnosis) who just sent me to PT that helped a little after 4 expensive months. Now I’ve started seeing a chiropractor who said my SI joint was out of whack and has been helping me with that. She now says I am slightly bowlegged with slightly fallen arches and wants to scan my feet for orthotics. I’ve never thought orthotics sounded like a “real” help for feet problems so I’m iffy about this course of treatment. What do you recommend for a long distance hiker if I have to be in shoes?

    • Personally I recommend Vivo Barefoot shoes but you may not be ready for those minimalist type shoes yet.

  65. Sierra permalink

    Thank you for this article. I’ve read many similar articles, previously, and in the past I have agreed with everything you said. I have FFF but I’ve never had any pain in my feet until recently. A long time ago I got rid of all my heels and bought shoes like the ones you recommend (flat, flexible sole). I wear those more idea shoes when I need to wear shoes, but most of the time I walk bear foot. Anyway, like I said, I’ve been doing the barefoot thing for a long time, but my left foot arch has just started hurting and it’s very concerning to me. Any suggestions?

    • Check out the articles on the Sock-Doc site, especially “Healthy People = Barefoot People” – and foot strengthening videos too.

  66. Liz permalink

    I am a 42 yr old female… I’ve had painful foot arch problems that happen in only one foot (either side) every 4-5 years. I don’t know what the cause is but it is extremely painful and usually starts one morning once I get out of bed and diminishes as I’m on it but comes back after I’ve had a nap or been off my feet for a couple hours and it lasts for about a week. What is this and what causes it? Thank you!!

  67. simmi aneja permalink

    i am 47years old women i have a right foot flat from last 20 days there is so much pain in the middle of my foot close to ankle thumb side doctor advised me to put some arch or sole but according this article barefoot are natural way to revert flat foot i m having one painkiller daily i am 80 kgs please help me lot of pain

  68. Shalmali Waingankar permalink

    Hi Sir,

    I have flat feet. After reading your article I came to know how serious it is. I always complaint my mom about my leg pain specially my foot. I also wear flat footwear as I cannot walk with heels and sandals. My age is 23 I work 6 days in a week. How can I decrease my foot pain? Please suggest.

  69. Dec permalink

    I have had shin splints (posterior) constantly throughout the course of my sports season for the past 5 years. (Soft or hard ground makes little or no difference) Several physios have highlighted that my arch collapses when I walk and I have over pronation. I’m a currently starting my third (and most severe) set of orthotics but Im not optimistic considering the previous orthotics had no benefit. Any recommendations? Thanks

  70. sukumar pathania permalink

    Nice article…..i have FFF, and I am 16 years old. I wear these silicone pads under my foot to treat it….can u plz suggest a remedy. I will be thankulto you.

  71. Ekta permalink

    Hi Doc,

    Read through your article, my daughter is 9 years and she has flat vagus feet. I am tired of showin orthopaedics and xrays and everytime i come out with the only solution that nothin can be done. I did buy support arc insert, birkenstock sandals. But my daughter still cries with the pain sometimes especially wen she plays or runs around. She was diagnoised with lower vitamin D and she had medication for a month. Appreciate if you can guide me. I reside in Dubai.

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  1. Barefoot Running & Walking: Minimalist Running, Shoes & Foot Health | Sock-Doc
  2. Overpronation Of The Foot | Pronation, Overpronation & Foot Injuries

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