Flexible flatfoot is usually symptom-free and allows an unrestricted life, and is considered a variant of normal in these circumstances.
However, there are cases in which the flexible flat foot causes pain (related to the greater activity of the musculature to stabilize the ambulation or with the overloads or hyper supports that it conditions), sensitivity in the internal edge of the foot, decrease of energy and rejection of the sport activities (in relation more than with the own flat foot with internal tibial rotation that is associated in almost 45% of the cases).
In these symptomatic cases, ruled out that it is a rigid flatfoot, measures can be established to reduce the problems associated with this condition:
- Modification of activities that provoke pain and use of temporary unloading orthoses.
- Physical therapy with strengthening of weakened muscle and ligament groups.
- Use of insoles: although it has been demonstrated that they do not change the evolution of flat feet, they can be useful to alleviate symptoms, modify the gait pattern and alleviate asymmetrical shoe wear. Not all children with flat feet should use insoles, as they contribute to making the sole of the shoe more rigid, thus hindering the development of the foot musculature.
- Modification of footwear: in general, footwear should be flexible, and barefoot walking exercises are recommended to strengthen the foot musculature.
Surgical interventions should be reserved for those exceptional cases of severe flexible flat feet that do not respond to the conservative measures described above.
These surgeries are indicated in most cases of rigid flat feet (secondary to abnormal joints between foot bones in adolescents, incorrect alignment of foot bones in infants, or neurological problems at any time during childhood development).
To summarize, flat feet are in most cases a benign condition (which can be considered physiological) that does not affect the daily life of children. There are, however, some pathologies that manifest as a rigid flatfoot and that do require action from the physiotherapeutic, orthotic and surgical point of view.