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Fallen Arches: Advice Sheet


What are fallen arches?

Having fallen arches or flat feet means you have very low arches or none at all, sometimes an individual’s are so flat that they press against the floor causing pressure.

The foot naturally has a curve or arch to it, this is sometimes referred to as an in-step – it is the part of the foot that is raised in the air while the rest of your foot is in contact with the ground.

In young children, it is common for them not to have a visible arch. This is because the foot is still forming and the arch is typically cushioned with baby fat and soft tissue. The arch will usually develop as they get older. However in some cases, individuals naturally have flat feet, and they never develop a visible arch. It is suggested that this could be inherited from parents.

Sometimes in adulthood, an individual with well-formed arches may notice that they are gradually lowering over time due to overuse or injury. This is a condition called Adult Acquired Flatfoot Deformity and is more likely to be associated with pain and injury.

What Causes Adult Acquired Flat Foot Deformity (AAFD)?

Posterior Tibial Tendon Dysfunction

Weakness or damage to this tendon is the most common cause of AAFD. Tibialis Posterior starts as a muscle next to the calf and runs down the inside of the lower leg attaching to the bones underneath the foot on the outside border. The main purpose of this muscle is to support the foot to maintain the arch while you are standing and walking. If the tendon is damaged or weakened it causes the arch to slowly lower over time.


Damage to the ligaments of the foot can cause the joints to change alignment. Ligaments work by supporting the bones and limiting excessive movements. If ligaments get torn they can result in a flat and painful foot. It is more common to occur in the middle of the foot but it can also present at the back of the foot behind the arch.

It is not just ligament damage that can result in a flatfoot deformity; fractured or dislocated bones in the midfoot can also result in a similar presentation.

Other Medical Conditions

Conditions like diabetes and rheumatoid arthritis can cause anatomical changes to the foot that change the appearance causing them to progressively flatten over time. If you suffer from one of these conditions and are concerned that these changes are happening to you then you should seek advice from your podiatrist, GP, or rheumatologist.

What should I do if I have Flat Feet?

Flat feet are usually nothing to be concerned about if a fallen arch causes no problems and is not painful, then treatment may not be needed. However occasionally flat feet can be associated with symptoms that may include:
– Painful or swollen feet,
– Ankle, knee, hip and lower back pain (usually worse with higher levels of activity),
– Feet that get tired easily (fatigued),
– Shoes that get worn out too quickly.

It is recommended to seek help and advice from a medical professional like a podiatrist or a physiotherapist if:

– Feet are still painful even after wearing well-fitting shoes with adequate heel support
– Your arches are getting progressively lower or flatter over time.
– Your shoes are being worn out unusually fast.
– Your feet are weak, stiff, or numb.

How will you be treated for fallen arches?

If you are in pain or discomfort, a podiatrist can make a diagnosis by examining the foot and lower limb. They will assess the muscles and bones in your feet and legs and see how they move and if there are any weaknesses or imbalances. They may also look at the bottom of your shoes to see if any unusual patterns are revealed by your walking movements.

In most cases, there will be no need for surgical intervention. Conservative treatments such as orthotics, braces, sports taping, and exercises are very effective ways to resolve the underlying problem and reduce the associated symptoms.

Orthotics can be used inside your shoes to help to realign the foot and reduce any excessive movements that may be aggravating your condition. This in turn will help the function and alignment of your ankles, knees, hips, and the lower back. These can be altered slowly to gradually adjust the foot and improve the way you walk (gait). A podiatrist is a foot specialist and is best qualified to advise on orthotics. An osteopath or physiotherapist may also be able to offer rehabilitation and treatment, in addition to stretching exercises to help keep the foot tendons stretched and working effectively.

In severe cases, however, surgery may be needed to repair the foot.

What can you do to help yourself if you have fallen arches?

There are many ways to look after your feet. First of all, stretch them regularly to keep the range of motion needed for functional walking. You can try rotating the foot in circles clockwise then counter-clockwise – this should be done in a slow and controlled manner. Regularly stretching your calf muscles and hamstrings will also help.

If you are in pain from your flat feet try icing the area using ice wrapped in a tea towel; this should be applied to the painful area and should relieve some of the discomforts. Over-the-counter medications can also be used to help with any pain, but ensure you always read the information leaflet first.

Always wear good fitting supportive footwear (e.g. a running trainer), and avoid flip-flops and high heels. Finally, avoid excessive activities and high impact sports if you are suffering from pain and discomfort in the foot. Please remember, if you need any further advice then you can email us at [email protected]

For more information about Fallen Arches

If you would like additional information about this or to discuss how we may be able to help with your queries please contact us using the form below and we will get back to you as soon as possible.

    Here are some of our E-Books to help you


    American Academy of Orthopaedic Surgeons, [Accessed 19/07/2016]
    NHS Choices,

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