What is Flatfoot (Pes Planus)?

Anatomy of the Medial Longitudinal Arch

The human foot relies on an architectural arch composed of bones, ligaments, and tendons that dissipates ground reaction forces. In flatfoot (pes planus), this medial arch flattens, placing direct biomechanical stress on the plantar fascia, posterior tibial tendon, and hindfoot joints.

Flexible vs. Rigid Pes Planus

Flexible flatfoot presents with an arch that reappears when non-weight-bearing or on tiptoes. Rigid flatfoot remains flat under all conditions due to tarsal coalition or severe osteoarthritis, frequently inducing chronic discomfort.

Recognized Symptoms

• Premature foot and calf muscle fatigue during standing or walking
• Medial ankle pain along the course of the posterior tibial tendon
• Abnormal shoe wear on the medial soles
• Hindfoot valgus (inward tilting of the heel)

Frequently Asked Questions

Does flatfoot always require treatment?

Asymptomatic flexible flatfoot in children and adults does not require active medical intervention. Custom biomechanical orthotics and calf stretching resolve symptomatic cases.

When is flatfoot surgery indicated?

Surgical reconstruction (osteotomies or tendon transfers) is indicated for rigid, progressive deformities failing conservative orthotic regimens.