Flatfoot Deformity

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Flatfoot deformity, often referred to as “fallen arches” (Pes planus), most commonly affects children’s feet. Typically, flatfoot doesn’t produce lasting or serious side effects. If an individual is experiencing pain from little or no arch of the foot, an orthopedic specialist can provide solutions to reduce and eliminate symptoms.

At OrthoAspen, our foot and ankle specialists are familiar and skilled with helping families navigate the symptoms and solutions associated with flatfoot deformity.

flatfoot deformity

Causes & Symptoms

When the arch that runs lengthwise along the sole of the foot has collapsed to the ground, or was never properly formed, the result is flatfoot deformity. Flatfoot is normal in the first few years of life as the arch of the foot usually develops between the ages of three and five.

There are two variations of flatfoot:

  1. Rigid Flatfoot
    Rigid pediatric flatfoot can cause joint pain in the leg when walking or an aching pain in the feet. This form of flatfoot usually requires intervention.
  2. Flexible Flatfoot
    This type of flatfoot usually resolves without any treatment needed unless pain is involved.

Pediatric flatfoot is a common hereditary condition. The condition is a result often caused by loose connections between joints and excess baby fat deposits between foot bones—making the entire foot touch the floor when the child stands. A rare condition called tarsal coalition can also cause flatfoot. In this condition, two or more bones of the foot join abnormally causing stiff and painful flat feet.

Children with flatfoot deformity may have one or more of the following symptoms:

  • Inside arch of the foot is flattened
  • Heel bone may be turned outward
  • Inner aspect of the foot may appear bowed out
  • Foot, leg, knee, hip or lower back pain
  • Heel pain leading to difficulty with walking/running
  • Pain and discomfort associated with wearing shoes
  • Inability to bear weight on affected foot
  • Tired, achy feet with prolonged standing or walking

Whenever possible, our OrthoAspen elite grade specialists will utilize conservative approaches to addressing flatfoot. Prior to devising the best orthopedic protocol for flatfoot, a full examination will take place. The first step in diagnosing flatfoot deformity is to conduct a physical examination of the foot and observe the child/patient in standing and sitting positions.

If an arch forms when the child/patient stands on his/her toes, then the flatfoot is flexible and no further tests or treatment are necessary.

If pain is associated with the flatfoot, or if the arch does not form when standing on the toes, then X-rays are ordered to assess the severity of the condition. A computed tomography (CT) scan is done if tarsal coalition is suspected, and if tendon injury is presumed, a magnetic resonance imaging (MRI) is recommended.


There are various methods of addressing flatfoot based on the type and severity of the condition, which include:

  • Conservative Treatment
    If no symptoms are exhibited your OrthoAspen physician may monitor the condition. For children, it’s important to observe any changes as they continue to grow. If, however, a child/patient has symptoms, your doctor may suggest some of the following non-surgical treatments.
  • Activity Modification
    Avoid participating in activities that cause pain such as walking or standing for long periods of time.
  • Orthotic Devices
    Your surgeon may advise on the use of custom-made orthotic devices that are worn inside the shoes to support the arch of the foot.
  • Physical therapy
    Stretching exercises of the heel can provide pain relief.
  • Medications
    Pain relieving medications such as NSAID’s can help to reduce pain and inflammation.
  • Shoe Modification
    Using a well‐fitting, supportive shoe can help relieve aching pain caused by flatfoot.
  • Surgical Treatment
    Although rare, surgery may be recommended to treat pediatric flatfoot if conservative treatment options fail to relieve symptoms. Depending on the severity and type of flatfoot, various procedures may be performed including tendon transfers, tendon lengthening, joint fusion and implant insertion.

If you’re concerned that you or your child may exhibit a flatfoot deformity, we encourage you to reach out to one of our friendly, experienced and knowledgeable OrthoAspen team members. It’s our goal to help improve the symptoms of flatfoot by offering specialized and focused care for our patients.

To schedule a consultation, simply click here to get started or call us at 970-544-1289.


Visit OrthoAspen in two convenient locations
Aspen Clinic
Aspen Valley Hospital
0401 Castle Creek Rd., Suite 2100,

Aspen, CO 81611
+(970) 544-1289
+(970) 544-1400
Basalt Clinic
Midvalley Medical Center
1450 E. Valley Rd., Suite 201,

Basalt, CO 81621
+(970) 544-1289
+(970) 544-1400