Adult acquired flatfoot is a foot and ankle condition that affects adults. It can be a debilitating condition that can be treated non-surgically with braces, orthotics and other devices.


What is adult acquired flatfoot?

Adult acquired flatfoot is a very common condition that affects both male and female adult feet and ankles. The arch of the foot falls or collapses in people with adult acquired flatfoot. It is a painful and sometimes incapacitating condition. However, braces, orthotics, and other non-surgical treatments can usually help with a painful flatfoot.

Adult acquired flatfoot differs from childhood flatfoot. Children usually grow out of flatfoot on their own, often without any treatment. Adults’ flat feet are usually permanently flat. Treatment usually focuses on alleviating symptoms rather than finding a cure.


Who develops adult acquired flatfoot?

Adult acquired flatfoot can affect any adult. However, the condition is more common in women over the age of 40. Pregnant women are also more likely to develop adult acquired flatfeet. Adults who have uncontrolled hypertension, diabetes, rheumatoid arthritis, or obesity are also at a higher risk.

People with flat feet as children are more likely to develop adult acquired flatfoot. Additionally, those with a family history of flatfoot may be predisposed to the condition.



The posterior tibial tendon may become inflamed or torn as a result of an acute injury. Overuse of the tendon can potentially cause it to rip. People who play high-impact sports, like basketball, tennis, or soccer, for instance, may develop tendon tears from repeated use. The arch will eventually collapse if the tendon gets irritated or ruptured.

Flatfoot can develop in diabetics due to a condition known as Charcot foot. This condition may also result in foot deformity. People with diabetes frequently have less feeling in their feet or neuropathy, so they may not notice when their foot collapses at first. This can result in more severe flattening prior to diagnosis. As a result of this severe collapse, even more serious issues may arise. As the arch collapses, the bones in the foot may break and disintegrate. This can lead to a severely deformed foot in the long run. It is possible that prescription bracing, footwear, or surgery will be required.



The tendon causes pain on the inside of the foot and ankle. This may or may not be related to swelling in the affected area.

Pain that worsens when you move. Running, for example, is a high-intensity or high-impact activity. Some patients may have difficulty walking or standing for an extended period of time.

Ankle pain on the outer side. When the foot collapses, the heel bone may shift to an outward position. This may put strain on the outside ankle bone. Arthritis in the back of the foot causes the same type of pain.


How is adult acquired flatfoot diagnosed?

A visual examination and plain radiographs of your feet are usually used to diagnose adult acquired flatfoot. By looking at your feet while standing with your full weight on your feet, your Canadian Certified Pedorthist should be able to tell if you have flatfoot or just “flexible flatfoot.” They may also ask you to stand on your tiptoes or heels to see if an arch forms.

If your pedorthist determines that you have adult acquired flatfoot, they will investigate the cause of your condition. Your treatment strategy will be determined by this.


Nonsurgical Treatment


The first step is to reduce or even stop activities that aggravate the pain. It is beneficial to switch to low-impact exercise. Biking, elliptical machines, and swimming do not place a significant impact load on the foot and are generally tolerated by the majority of patients.



To reduce swelling, apply cold packs to the most painful area of the posterior tibial tendon for 20 minutes at a time, 3 or 4 times per day. Ice should not be applied directly to the skin. Applying ice to the tendon immediately after exercise helps to reduce inflammation around the tendon.



Orthotics and braces can help the majority of people. An orthotic is a type of shoe insert. It is the most widely used nonsurgical treatment for flatfoot. For patients with a minor change in foot shape, an over-the-counter orthotic may suffice. Patients with moderate to severe changes in the shape of their feet require a custom orthotic. The custom orthotic is more expensive, but it allows the doctor to better control the foot position.



Mild to moderate flatfoot may benefit from a lace-up ankle brace. The brace would support the back of the foot joints and relieve tension on the tendon. In cases of severe flatfoot that is stiff or arthritic, a custom-molded leather brace is required.

For the best advice, talk to your Canadian Certified Pedorthist. Their valuable expertise can help you make the best-informed decision when it comes time to purchase.


Written by Reza Sands