Flat feet in adults: should you wear orthotics?

Flat feet and foot orthotics are a topic that raises many questions among adults. It is estimated that about twenty percent of the adult population has some degree of fallen arches. But do all flat feet require correction? The answer is nuanced and depends on several factors that we will explore in this article.

What are flat feet in adults?

Flat feet are characterized by a partial or complete collapse of the arch. In adults, there are two main types. Flexible flat foot, the most common, has an arch that collapses under body weight but reforms when the foot is not bearing weight. Rigid flat foot, which is rarer, stays flat in all circumstances and is often linked to a bone or joint abnormality. In both cases, the relationship between flat feet and foot orthotics deserves to be assessed by a professional.

Symptoms of symptomatic flat feet

A flat foot is not necessarily a problem. Many people live with flat feet without ever experiencing pain or functional limitation. However, when symptoms do appear, they can include pain under the arch or in the heel, rapid fatigue of the feet and legs, knee or lower back pain, swelling along the posterior tibial tendon and difficulty standing on tiptoe. These symptoms indicate that the flat foot is placing excessive strain on the musculoskeletal structures.

When are foot orthotics necessary?

The decision to prescribe a foot orthotic for flat feet is based on a complete biomechanical analysis. If the flat foot is asymptomatic and causes no limitation, intervention is generally not necessary. However, if pain is present, if excessive pronation is observed or if the flat foot contributes to joint problems further up the chain, the connection between flat feet and foot orthotics becomes therapeutically relevant. The orthotic then aims to support the arch, limit pronation and redistribute pressure to relieve the structures under strain.

How do orthotics help flat feet?

A foot orthotic designed for flat feet typically includes a pronounced medial support that fills the space left by the fallen arch. This support redistributes pressure toward the arch and the lateral arch, reducing overload on the heel and forefoot. A pronation-control element is often added to stabilize the rearfoot and prevent excessive inward rolling. The result is better alignment of the lower kinetic chain, from the foot up to the pelvis.

Complementary exercises

Alongside flat feet and foot orthotics, a strengthening exercise program is often recommended. Strengthening the posterior tibial muscle, the arch’s main dynamic support, can improve foot function. Toe-gripping exercises, heel raises and calf stretches help improve stability and proprioception. Your orthotist can recommend a program tailored to your specific condition.