Pes Planus/fallen arch or more commonly known as a flat foot. There is an arch on the inner sides of the sole of the foot that extends from heel to base of the great/ big toe. When this arch is flattened, it is called flat foot. Babies are often born with the flat foot. The majority of children have a flat foot, 95% of which grows into a normal arch by six years of age and feet become less flexible. 

Types of flat foot:

1. Based on the type of arch- Rigid and flexible: Irrespective of sitting or standing posture, if the entire foot touches the ground or there is no arch, it is called a rigid flat foot. Whereas, if the person tiptoes or sits, the arch is present and disappears on standing, it is called flexible flat foot. Flexible flatfoot may also be known as “pediatric foot” since it is apparent in childhood and is usually seen bilaterally. Rigid or ‘true’ flat foot is very less common in children, also known as talipes Plano valgus.

2. Based on the cause; congenital and acquired: Congenital means that the child was born with a flat foot that never developed the arch as he/ she progressed to the adulthood. The flat foot may be acquired, contributing to factors such as ageing, illness, obesity or injuries to tendons, etc. This type may be present unilaterally as well.


The flexible flat foot is usually symptomless unless the Tendon Achille is short which may cause discomfort or pain around arch area, difficulty in standing on tiptoe. The symptoms may aggravate after athletic activities. The rigid flat foot makes running difficult or painful due to stress placed on ankles. The foot may be rolled inwards causing shoes to wear out quickly. The general alignment of legs may be disrupted and the knees may acquire early osteoarthritis due to faulty biomechanics.

Treatment options:

1. A flexible flat foot that doesn’t hurt would not require any treatment usually.

2. If the pain is felt in feet or legs after activities, arch supports or shoes with built-in arch supports are recommended. Exercises should be done to strengthen the foot muscles and the tendon Achilles or calf muscle should be stretched.

3. Surgical treatment is rarely required but may be done in the rigid flat foot if the symptoms are too much bothersome.  

Exercises for strengthening foot muscle:

1. Foot curls: Place a flat hand towel under the foot and try to curl it in a way that the ball of the toes and heel come closer. 

2. Heel raises: Stand on the feet and try standing on tiptoes. Hold for15-20 seconds and 10 such repetitions, thrice daily.

3. Toe raises: Stand on the feet and raise the front toes. Hold for15-20 seconds and 10 such repetitions, thrice daily.

4. Heel walk and toe walk: Practice few minutes of walking on toes and heel to strengthen up the muscles.

5. Calf stretches: Keep your one leg forward and extend the other leg straight back, placing the heel flat on the floor. Don't bend the knee of the leg at the back. Lean towards the wall until you feel a stretch in the calf of the straightened leg. Hold for 20 seconds for each leg and 10 such repetitions. It can alternatively be done in sitting position with the leg straight and using a towel to pull the toes towards one, till a stretch is felt in the calf muscles. Hold for 15-20 seconds and repeat 10 times for each leg. 

Always consult your medical practitioner before following any of the regimes. These are generalized exercise regimes which may or may not cater to personal needs.