Flat Feet? Lift Your Sole

Image of family sledding

Pain at the Ankle 

Flat feet can cause serious pain and lead to further issues down the line if not properly treated early on. There are many factors that can lead to flat feet. The most common are genetics, trauma, an accessory bone within the tendon, or a coalition, which is an abnormal connection between two bones near the ankle which act as a tether, and the foot can subsequently become flat.

What are the symptoms?

Symptoms for flat feet typically include pain at the inside or outside of the ankle. Increased activity, prolonged standing, and walking on uneven ground can also cause a great deal of pain for a person with flat feet.

Who’s at risk?

Women are three times more likely to have flat feet than men. Although flat feet can happen at any age, it is most commonly seen in middle aged adults.

One Hour Could Change Your Life

Hear more from foot and ankle specialist, James Maskill, DPM, about safe and effective treatment options for flat feet in the video to the left. To find a foot and ankle specialist near you, visit

What treatment options are available?

There are four stages of posterior tendon dysfunction (PTTD), also known as adult-acquired flat feet. The stage you are in is a big factor in determining the treatment you need.

Stage 1: During this stage, you have pain and weakness within the tendon, but you have a normal foot and no deformity.

Stage 2: Pain occurs along the tendon, or the outside of the foot and ankle become painful. However, your flat foot is flexible. This means you can still turn your foot from side to side. A person in stage two can usually walk on uneven ground with no issues.

Stage 3: The in and out movement in your foot has become fixed. This means it is now arthritic. This typically happens after years of having flexible flat feet without treatment.

Stage 4: After years of having a fixed deformity, your ankle turns and becomes flat. This causes you to almost walk on your ankle bone.

Conservative treatment options include custom orthotics, bracing, medication, injections, and physical therapy. However, the most important thing you can do is stretch your Achilles tendon. The Achilles tendon is one of the strongest tendons in your body and gives your foot the ability to move up and down. Flat feet causes this tendon to become tight and stretching can help relieve some of that stress.

If there is no progress with conservative treatment, patients may eventually need surgical treatment. The type of surgery needed depends again on the stage of PTTD you are in.

“We try to stop the disease at whatever stage the patient comes in with. The last thing I want is for someone to progress to the next stage because it becomes more difficult and the outcomes may not be as good with conservative or surgical management.”

Three easy steps to stretch your Achilles tendon:

  • Put the front half of your feet on the edge of a stair or any stable raised platform.
  • Hold on to a railing or another form of support to maintain your balance.
  • Slowly lower your heels to the lowest point possible without pain and back up again.

Image of James Maskill, DPM


“I’ve seen flat feet in people from age eight to 80. If it’s painful, it’s treatable.”

- James Maskill, DPM

Related Videos

View All Related Videos
Your generosity can make a difference.