Flat feet

Flat feet are common, and for most people they're simply the way their feet are made. They usually don't cause any problems and don't need treatment.¹,² But if your feet or legs ache, or one arch has started to drop when it didn't before, it's worth getting them checked.

What are flat feet?

Most feet have an arch on the inside, so the middle of the foot doesn't touch the ground when you stand. With flat feet (also called fallen arches or pes planus), the arch is lower than usual and the inside of the foot sits flat or nearly flat on the ground.¹,²

To check, look at the inside of your feet while you're standing. If the arch is raised off the ground, you don't have flat feet.² Many people's arches flatten a little when they stand and lift again when they sit or stand on tiptoe. This is called a flexible flat foot.

It's normal for babies and young children to have flat feet. Most children develop an arch between the ages of 3 and 10.¹,²

What causes it?

Often there's no obvious cause. Flat feet tend to run in families.¹,² In young children, a soft fat pad under the arch makes the foot look flat.¹ Some health conditions that affect the joints, muscles or nerves can also cause flat feet.¹,²

In adults, an arch can lower over time. Stretching of the tissues in the foot after an injury, with age or with extra body weight can play a part.²

One cause in adults deserves a special mention: a problem with the tibialis posterior tendon, which runs behind the inside ankle bone and helps hold up the arch. When this tendon is damaged, the arch gradually collapses, usually in one foot. It's most common in middle-aged women and tends to get worse over time.³ It's often mistaken for an ankle sprain or arthritis,³ so a new flat foot in an adult should be checked.

Signs and symptoms

Many people with flat feet have no symptoms at all.¹,² When they do cause problems, you may notice:

• pain or tiredness in your feet, ankles or legs, especially during or after activity¹
• aching along the arch, or pain around the ankle or lower leg²
• stiffness or swelling in your feet or ankles¹
• shoes wearing out quickly, often on the inside of the heel¹,²
• in children, tripping or falling more often than other children.¹

With a tibialis posterior tendon problem, the first signs are often pain or swelling on the inside of the ankle and along the arch.³

What can help?

If your flat feet don't hurt or cause problems, you don't need to do anything.¹,² They shouldn't stop you from doing any activity, including sport.²

If they are causing symptoms:

• Supportive shoes. Choose shoes that fit well, with a low heel, and that suit the activity you're doing. Avoid shoes that are too tight, too loose or worn out.¹,²
• Orthoses (shoe inserts). Orthoses can help with pain or tiredness, but they won't change the shape of your feet.¹,² For adults with flexible flat feet, orthoses can reduce pain a little.⁴ For children, the evidence is unclear, and there's no good evidence that orthoses can stop flat feet from forming.¹,⁴
• Exercises. Physiotherapy can help reduce symptoms,¹ and strengthening and stretching exercises are often part of a treatment plan.
• Surgery is rarely needed. It's only considered when there's a problem with the bones, tendons or muscles of the foot and other treatments haven't worked.²

At Foot Ankle Lower Limb, we look at how your feet are shaped and how they move when you walk, and work out whether your foot shape is actually linked to your pain. Treatment may include footwear advice, exercises and orthoses, and sometimes other therapies alongside them.

When to see a podiatrist

See a podiatrist or GP if:

• your feet are painful, stiff, weak or numb
• you often injure your feet or ankles
• you have trouble with walking or balance
• your arch has dropped recently, or one foot has become flatter than the other.²,³

Get your child checked if they are under 8 and keep falling or have trouble walking, are 8 or older and have pain or trouble moving because of their flat feet, or have a stiff flat foot, pain or a limp.¹

If you have diabetes, poor circulation or reduced feeling in your feet, have any foot pain checked promptly.

If your flat feet are causing pain, book an appointment with our podiatrists in Booragoon.

References

1. healthdirect Australia (2025). Flat feet (fallen arches). https://www.healthdirect.gov.au/flat-feet
2. NHS (2025). Flat feet. https://www.nhs.uk/conditions/flat-feet/
3. Kohls-Gatzoulis J, Angel JC, Singh D, et al. (2004). Tibialis posterior dysfunction: a common and treatable cause of adult acquired flatfoot. BMJ, 329(7478), 1328–1333. https://doi.org/10.1136/bmj.329.7478.1328
4. Oerlemans LNT, Peeters CMM, Munnik-Hagewoud R, et al. (2023). Foot orthoses for flexible flatfeet in children and adults: a systematic review and meta-analysis of patient-reported outcomes. BMC Musculoskeletal Disorders, 24(1), 16. https://doi.org/10.1186/s12891-022-06044-8

Reviewed by Andrew Schox, Podiatrist, BSc(Hons) PGradDipPod MPod. Last reviewed October 2026.