Are flat feet (pes planus) a problem?

Flat feet are common and often painless. They may become a problem when load, footwear, or training changes outpace your foot and ankle control, causing arch, heel, shin, or knee pain.

Can physiotherapy help flat feet?

Physiotherapy may help by improving foot and ankle strength, arch control, balance, and movement patterns, while also guiding footwear choices and training load to reduce flare-ups.

Do I need orthotics for flat feet?

Not always. Some people benefit from temporary or targeted orthotic support during painful phases or high-demand work, but many manage well with strengthening, load management, and supportive footwear.

What exercises help flat feet?

Many programs use foot intrinsic strengthening, arch control drills, calf strengthening, and balance work. A physiotherapist can match exercises to your symptoms and progress them safely.

When should I get flat feet checked?

Book an assessment if you have ongoing arch or heel pain, inner ankle pain or swelling, repeated shin splints, changing foot shape, or pain that limits walking, work, or sport.

Flat Feet (Pes Planus)

Article by John Miller & Erin Runge

Flat foot vs normal foot footprint comparison showing pes planus arch collapse — Comparison of a normal foot arch and flat foot (pes planus) using footprint patterns.

Flat feet (pes planus) means your foot arch sits lower than usual, so more of the sole contacts the ground. Many people have flat feet and feel fine. However, others notice arch pain, heel pain, shin splints, or knee discomfort, especially after long days on their feet or higher-impact sport.

Flat feet often link with overpronation (your foot rolls in more than usual). Over time, that can change how load moves through your feet and legs. The good news is that many cases respond well to physiotherapy-led foot care, targeted strengthening, and footwear changes.

Quick self-check: after a shower, look at your wet footprint. If you see very little inner-arch curve, you may have lower arches. That test is not a diagnosis, but it can guide whether you book an assessment.

Also, watch your shoes. If the inner edge of the heel wears down faster, your feet may roll in more with walking or running. Next, pay attention to how your ankles look when you stand relaxed. If your heel tilts outward and your inner ankle collapses inward, you may load the arch more than your tissues can tolerate. Finally, notice patterns: do symptoms flare after long shifts, new footwear, or a sudden training increase? These clues help a physiotherapist work out whether pain comes from the arch itself, a tendon overload, or a workload that rose too quickly. In turn, that guides a practical plan rather than “one-size-fits-all” advice.

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What causes flat feet?

Flat feet may be present from childhood or develop later. Common contributors include:

Flexible flat feet (arch appears off-load, flattens with standing)
Muscle control changes in the foot and ankle (including arch stabilisers)
Footwear and load spikes (new job on your feet, sudden running increase)
Weight changes that increase demand on the arch
Tendon overload, especially the tibialis posterior tendon in some adults

People also ask: Do flat feet always cause pain? No. Many people have flat feet without symptoms. Pain usually appears when the arch and ankle control cannot manage your workload, footwear, or training changes.

Common symptoms

arch or heel pain (often after activity)
tired feet or cramping in the sole
inner ankle ache or swelling
shin pain with running or jumping
knee pain with stairs or squats

Complications linked with flat feet

Physiotherapy treatment options for flat feet

Improve arch and ankle control

Targeted “foot core” work and graded strengthening can improve arch control and reduce overload.

See: Active Foot Posture Correction Exercises.

Orthotics (when they suit your needs)

Orthotics may help some people during painful flare-ups or prolonged standing demands.

See MedlinePlus: Flat feet.

References

Jaffri AH, Ahmed S, Razak A, et al. Evidence for intrinsic foot muscle training in improving foot function: a systematic review. Sports Med Open. 2023;9(1):87. https://pmc.ncbi.nlm.nih.gov/articles/PMC10784881/
Jia Y, Wang Y, Zhang Y, et al. Comparing the efficacy of exercise therapy on adult flexible flatfoot. Sci Rep. 2024;14:16498. https://www.nature.com/articles/s41598-024-72149-w
Molina-García C, Jiménez-Rejano JJ, Castro-Méndez A, et al. Efficacy of plantar orthoses in paediatric flexible flatfoot. Children (Basel). 2023;10(2):371. https://www.mdpi.com/2227-9067/10/2/371
Peters-Dickie JL, McPoil TG, Cornwall MW, et al. Effects of foot core exercises and minimalist footwear on foot function: a systematic review and meta-analysis. Clin Biomech. 2025;110:106082. https://www.sciencedirect.com/science/article/abs/pii/S0268003324002493

Feet Products

These feet products are commonly used by our physiotherapists to improve support, comfort, strength, balance, flexibility, and home exercise programs.