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Flat Feet. When do you need help?

Everyone has different feet.

Foot "positions" range from very flat (Pronated) feet to extremely high arched (Supinated) positions.

A "Neutral" foot position is largely desirable for it encourages correct biomechanical movement between the joints and soft tissue structures (ligaments/tendons/muscles/nerves).


Having a more neutral foot generally reduces the risks of injury.

Footwear, strengthening and orthotics all help to maintain or strive for the most optimal foot position by providing extrinsic and intrinsic support for the joints to enable them to move in the best way.

Most of the population has a "pronated" (or slightly flat) foot type. This is normal to an extent.


Throughout walking, the foot flattens to absorb shock. This flattening allows better balance and adaption to terrain. Before stepping off, the arch rises into a position of higher arch which locks up the foot bones and allows for efficient propulsion.

Flat feet differs from person to person. Often, we treat flat feet... but occasionally leave them be!

The way we treat flat feet differs from person to person.

Flat feet/Pronation is normal until it becomes more severe, and the increasing flatness of the arch and deviation of the ankle can have increasing consequences on not only the foot and ankle, but the big toe joints, knees, hips and spine.


In Adults, flat feet can still change over time as hormones and muscle/tendon/ligament strength changes.

However, by adulthood the feet have finished their normal development and usually resemble what they will be for the rest of the someone's life.

In adults, flat feet that are asymptomatic (not painful) is usually not treated. This does, of course, depend on the magnitude of the condition. With an increase in pronation/flattening of the arch, there is an increased demand for muscle, tendon and ligament strength to support the bones. Often, this increased demand can result in various lower limb conditions such as Plantar Fasciitis, Achilles Tendinopathy, Bunions, knee and hip pain (to say the least).


In children, flat feet is normal for the first several years of age. Children have flat feet because they are born without key bones in their arches having yet developed. Over time, children will develop tendon attachments to bones and the bones will attach to each other via ligaments and form a regular foot shape and arch. Full and final development of the foot can take until the end of puberty, however an arch in the foot should be present by age 6.


Often, like adults, flat feet is not treated in children. Times where the foot requires increased support for young people includes if they are having problems walking, their feet deviate from the normal range of pronation or they have uneven foot posture.

As Podiatrists, most children we see have normal gait for their ages. Any advice and any treatment that we do provide usually is sufficient for management of their flat feet, but we do work closely with GP's and other healthcare professionals to assist with a treatment plan of a child who does require additional support.


Often, our first line treatment for flat feet is education.

We assess in- chair foot position and range of motion, standing and walking gait.

Individual factors that may be contributing to pain are noted and a plan made for pain resolution. Pain from flat feet is usually from Tendinopathies and ligament/muscle strains, however may be nerve compression or arthritis etc.

Common therapies for flat feet include:

  1. Muscle strengthening: Keeping the calves and small muscles within the feet strong helps to enable the foot to be better supported whilst increasing the resilience of the muscles to resist strain.

  2. Footwear assessment: Wearing appropriately supportive shoes is paramount in maintaining healthy and strong feet. Often clients present with worn out shoes, wearing a size too small or a non- supportive shoe brand. Footwear is the base of good foot support.

  3. Orthotics: Individualised insoles are often used and very successful for people with symptomatic flat feet. Orthotics provide an external force to the foot to support the joints which can be slightly out of position. Allowing physical support in the form of an orthotic enables the muscles and joints to work optimally therefore improving the gait and allowing muscles to strengthen more efficiently.

  4. Physical therapy: Management of painful flat feet at the clinic can be very effective when combined with the above management plan. We offer multiple physical therapy modalities that we use for painful flat feet such as:

  • Shockwave Therapy

  • Interferential/TENS Therapy

  • High Powered and Low Level Musculoskeletal Laser

  • Therapeutic Ultrasound

  • Dry Needling

  • Prolotherapy

  • Massage therapy

  • General skin and nail care.

Often, skin and nail concerns appear in relation to flat feet as forces acting through the foot change how the toes and skin interacts with pressure. Often ingrown nails, corns and callouses appear and can be very painful. This is easy for Podiatrists to assist with in the short and long term.

Some Products that can assist with painful flat feet include:

  • OS1st support socks: support for the ankle and arch regions

  • Theraband: for muscle strengthening

  • Fisiocrem: a natural anti-inflammatory rub

  • Toe separators: assist with corns and callouses, and deviating toes.

  • Over the Counter and Customised Orthotics: various range of arch supports

  • Footwear: our footwear brands are all Podiatrist tested for appropriate foot support

  • Spiky Balls: for release of tight and sore muscles

If you have any questions about flat feet or any foot pain, come and see us or contact at Foot Body Sole

(03) 8648 7678

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