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🏥 Gotokuji Orthopedic Clinic / Patient Guide

Flatfoot Pain and Risks

No treatment is needed if you have no symptoms. If pain continues, come and talk to us early

Flatfoot means the arch of the foot sits low. In many people this is simply part of the natural variation in foot shape, and no treatment is needed when there is no pain or other symptom. Plenty of people have flat feet and never have any trouble.
When a painful flat foot is ignored, however, the inward roll of the foot (overpronation) keeps loading the plantar fascia and the posterior tibial tendon. Over time this can be associated with plantar fasciitis, bunions, or shin splints.
In children, the arch usually forms on its own as they grow, in most cases by around the age of 10.

1
The foot rolls inward (overpronation)

With a low arch, the foot tends to tilt inward with every step

2
Load builds up on the plantar fascia and posterior tibial tendon

Tissues on the sole and behind the inner ankle are pulled again and again

3
Pain appears, and can linger if you push through it

When the same spot keeps taking the load, the pain can become long-lasting

4
Strain can spread to the shin, knee, and lower back

A change in foot alignment travels upward and may show up as shin or knee pain

⚖️ Weight gain🧍 Long hours on your feet👟 Ill-fitting or very soft shoes🏃 A sudden jump in activity
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Pain from the heel to the arch (the first step in the morning hurts)
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Pain or swelling behind the inner ankle
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Your feet tire quickly when you walk for a while
Pain has started in the inner shin or the knee
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Pain lasting more than 2-4 weeks even after changing shoes, or one arch dropping quickly
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Reviewing Your Shoes
A firm heel counter that resists twisting, in a width that fits. Very soft shoes can add to the load
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Insole Therapy
Steadies the heel and the axis of the foot and spreads the load to ease pain. It does not correct the deformity itself
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Calf Stretching
Tight calves make the foot roll inward more easily. One or two minutes a day is enough to start
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Foot Muscle Training
Short foot exercises and towel curls. Stop if the pain increases
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Pain Relief
When inflammation is strong, we combine anti-inflammatory medication, physical therapy, and exercise guidance
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Specialist Care Including Surgery
Surgery may be considered in advanced cases. We do not perform surgery here, so we refer you to a partner hospital
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With no symptoms, there is no need to rush into treatment

When there is pain, the aim is to take load off the foot and ease the symptoms with better shoes, insoles, stretching, and muscle training. Most people can carry on with daily life this way. If pain is ignored for a long time, though, it can become long-lasting, or the deformity can progress until it takes more to manage.

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Please see us early if you notice these signs.
Pain or swelling behind the inner ankle, one arch dropping quickly on that side alone, difficulty standing on tiptoe, or pain lasting more than 2-4 weeks even after changing shoes. These can point to a posterior tibial tendon problem (adult acquired flatfoot), a type that tends to progress over time. Numbness, warmth, marked swelling, or pain at night is also worth checking so that other conditions can be ruled out.

💡 What to keep in mind when your feet hurt

  • If you have no symptoms, there is no need to rush out and have insoles made
  • When it hurts, start by reviewing your shoes (firm heel, the right width)
  • Insoles spread the load and ease pain, but the wrong pair can make pain worse
  • Keep stretching and muscle training within a range that does not increase your pain
  • If pain or tiredness in your feet continues, please come and talk to us early