®Wall calf stretch
Hold onto a wall or a chair. Take the leg you want to stretch straight behind you and bend your front knee. Keep your back heel on the floor; feel the stretch in your calf.
Hold for 30 seconds, 3 repetitionsAges 3–10The age range in which the arch of the foot usually develops in children
16 trialsThe Cochrane review of insoles in children; 1,058 children
67 / 79Out of 100 children, the number pain-free after one year: with custom insoles and with shoes alone (the difference is not significant)
5 situationsThe number of situations in which you should see a doctor; listed below
What is it?
You can check for yourself: stand up and look at the inner side of your foot. If your foot sits completely flat on the ground with no gap, you have flat feet; if the inner edge is raised off the ground, you do not.
Often there is no obvious cause; it is simply how your feet are, and it can run in families. More rarely it is caused by the bones of the feet not developing fully in the womb, by the tissues being stretched through injury, ageing or excess weight, or by conditions affecting the muscles, nerves and joints.
If it causes symptoms
- Pain around the ankle or in the lower leg
- Aching along the inner edge of the foot
- Shoes wearing out quickly
If you have none of these, flat feet is just a foot shape.
Flat feet in children
Most young children have flat feet. The inner arch of the foot usually develops between the ages of 3 and 10. If your child’s feet are not causing problems, you do not need to do anything.
On insoles the research is clear: in the Cochrane review of 16 randomised controlled trials (1,058 children), no significant difference in pain was found between custom-made insoles, ready-made insoles and shoes alone in children with painless flat feet. The authors state that they found no evidence supporting costly custom insoles for healthy children without pain. Insoles may help in conditions where the foot is painful, such as juvenile arthritis.
An arch that drops in adulthood
The most common cause of flat feet appearing in adulthood is strain and weakening of the tendon that runs behind the inner ankle bone to the sole of the foot and holds the arch up (tibialis posterior). The risk rises with age; it is more common in middle-aged women. Excess weight, diabetes, inflammatory arthritis and a blow or sprain to the area set the scene.
In this case the first step is to reduce the load: cutting down for a while on the walking and sport that increase the pain, applying ice with a towel in between, wearing a sturdy lace-up shoe and using an insole if needed. If the tendon has torn, surgery may be considered.
Treatment
The measures below do not change the shape of the foot; the aim is to ease pain and stiffness.
- FootwearWide, comfortable shoes with a low heel are usually best.
- InsolesThey can ease pain by supporting the foot; not needed if there is no pain.
- Stretches and exercisesThey stretch the calf and strengthen the muscles that hold the arch.
- PainkillersWhen needed, after asking your pharmacist or doctor.
- Foot specialistYour doctor may refer you to a physiotherapist or a podiatrist.
- SurgeryRarely needed; considered if there is a problem with the bones, tissues or muscles and other measures have not worked.
Exercises at home
Six exercises for flat feet
These exercises are for working the muscles that support the arch in painful flat feet. They can be done several times a day; stop any exercise that clearly increases your pain.
Lifting the arch
Sit with your foot flat on the floor. Tighten the muscles in the sole as if shortening your foot, and raise your arch; do not curl your toes, keep them flat on the floor. Hold for a few seconds and relax.
10 repsPressing the big toes together
Sit on a chair or on the floor. Press the inner edges of your two big toes together and hold.
Hold for 5 seconds, 10 repetitionsDouble-leg heel raise
Stand upright holding onto a worktop. Rise onto the toes of both feet and lower slowly. Do not let your ankles roll in or out as your heels rise.
10 repetitions, 3 setsSingle-leg heel raise
Once you can do the double heel raise comfortably, move on to one foot. Holding on, rise onto the toes of one foot and lower slowly.
As many as you can, working towards 10 repetitionsSingle-leg balance
Balance on one foot, holding onto something if needed. As it gets easier, try it on a soft surface such as a pillow.
30 seconds, 3 repsVideo
Videos for flat feet
From the YouTube channels of Dr James O’Donovan, a doctor in the UK, and Dr Tom Walters, a physical therapist in the USA (Rehab Science).
Seven exercises for flat feet
An exercise video demonstrated by a doctor and a physiotherapist.
Two movements to strengthen the arch
A video showing two movements that work the muscles lifting the arch of the foot.
Frequently asked questions
Do flat feet need to be treated?
Usually not. Flat feet generally cause no problems, do not stop you doing sport and are rarely a sign of anything serious. If there is no pain, stiffness, weakness or balance problem, nothing needs to be done.
My child has flat feet; should I buy insoles?
Most young children have flat feet; the arch usually develops between the ages of 3 and 10. If there is no problem, nothing needs to be done. The Cochrane review of 16 trials (1,058 children) found no evidence supporting costly custom insoles for healthy children without pain.
Do insoles correct the arch of the foot?
No. Insoles, suitable shoes and exercises do not change the shape of the foot; they can, however, ease pain and stiffness. That is why they are recommended only if there are symptoms.
Can flat feet develop later in life?
Yes. The tissues of the foot can stretch through injury, ageing or excess weight; in adults the most common cause is weakening of the tendon that runs behind the inner ankle and holds the arch. See a doctor if you did not have flat feet before, or if only one foot is affected.
When should you see a doctor?
See a doctor if you have flat feet and any of the following applies to you:
- Your feet are painful, stiff, weak or numb
- You often injure your feet or ankles
- You have problems with walking or balance
- You did not have flat feet before
- Only one foot is affected
Sources
- Evans AM, Rome K, Carroll M, Hawke F. Foot orthoses for treating paediatric flat feet. Cochrane Database Syst Rev. 2022;(1):CD006311.
- NHS. Flat feet. Page last reviewed 24 June 2025.
- NHS Borders. Posterior tibial tendon dysfunction (PTTD). Patient information leaflet.