Adult flat feet can be painful and limit participation in weight bearing activity. While most adults with flat feet are primarily symptom free, about 5% of the population will have significant limiting pain in the foot, ankle or knee directly related to flat feet. This typically occurs due to laxity of the ligaments or a joint structure that is insufficient to keep the stress of weight bearing lined up over the ankle and foot to use the structure of the bone to bear most of the weight.
Treatment of adult flat feet is simple but requires some work and adjustment from each patient. The three-fold approach includes, stretching muscles that may feed into the stressful position contributing to the flat foot, building strength in the muscles that have allowed the foot to collapse, using an orthotic as a temporary or sometimes permanent support, adopting a pattern of exercise for the long term of 6 months or more, and changing footwear. Despite its simple (maybe not so simple to some patients) solution, the roadmap and timing of these components should be put together by a physical therapist to ensure that the plan is addressing each patients needs in the right progression and to the right degree. Custom orthotics from a therapist who understands biomechanics is often the only treatment needed.