Flat Foot
Fallen arches in children and adults
Flat foot (pes planus) is a condition where the arch of the foot collapses, causing the entire sole to contact the ground. It can be flexible (usually painless in children) or rigid (often painful and progressive in adults).
Symptoms
- Pain along the inner side of the ankle and arch
- Fatigue after standing or walking
- Uneven shoe wear
- Difficulty standing on tiptoes
- Knee, hip, or lower back pain from altered gait
Common Causes
- Congenital / hereditary
- Tibialis posterior tendon dysfunction (adult acquired flat foot)
- Rheumatoid or inflammatory arthritis
- Diabetes-related tendon changes
- Previous trauma or fracture
How We Diagnose
- Weight-bearing X-rays with specific angle measurements
- MRI of the tibialis posterior tendon
- Standing gait & pedobarography analysis
Recovery Timeline
Orthotics provide relief within weeks. Post-surgery, protected weight-bearing for 6 weeks, full activities by 4 months.
Conservative first. Surgery when it's the right answer.
Conservative treatment
Custom orthotics
Medial arch support with heel wedge — first-line for flexible flat foot.
Physiotherapy
Tibialis posterior strengthening & calf stretching.
Surgical treatment
Minimally invasive HyProCure / Arthroereisis
A small titanium implant that restores the arch — day-care surgery.
Reconstructive foot surgery
For rigid/adult acquired flat foot — combined tendon transfer & osteotomy.
Why. When. Can. How long. Surgery?
Flat Foot usually develops from a mix of mechanical overload, previous injury, footwear and biological factors. Identifying the specific driver is the first step to a treatment plan that actually works.
Book a review if pain lasts more than 2–3 weeks, disrupts sleep or work, comes with swelling or deformity, or if you have diabetes or a previous foot injury.
Yes — most cases respond to structured conservative care. Surgery is only offered after an appropriate non-surgical trial has genuinely failed or if structural damage is progressing.
Mild cases settle in 2–6 weeks; moderate cases in 6–12 weeks; surgical cases follow a structured 3–6 month rehabilitation programme.
Not usually. Surgery is reserved for structural damage or true failure of conservative care — decided together after a full review of your history, examination and imaging.
Often yes, with condition-specific physiotherapy, footwear/orthotic optimisation, activity modification and injections where indicated — provided the plan is followed properly for long enough.
Delay allows the underlying mechanics to progress — ligaments loosen, cartilage wears, deformity becomes rigid. Late-stage reconstruction is always bigger than early treatment.
Flat Foot — 12 frequently asked questions
My child has flat feet — is it serious?+
Flexible flat feet in children under 8 are usually normal and painless. Only painful, rigid, or asymmetric flat feet need specialist evaluation.
Are orthotics enough for adults?+
For early tendon dysfunction, yes. Advanced collapse usually needs surgical correction to prevent arthritis.
Why is flat foot affecting me now?+
Flat Foot is usually the result of accumulated mechanical stress, an untreated older injury, or a change in activity, footwear or body weight. A structured evaluation identifies the exact driver so treatment targets the cause, not just the symptom.
When should I see a foot & ankle specialist for flat foot?+
If pain lasts more than 2–3 weeks, wakes you at night, causes limping, prevents sport or work, or comes with swelling, deformity or numbness — book a specialist review. Early expert care almost always prevents surgery later.
Can flat foot be treated without surgery?+
Yes — the majority of patients improve with a structured conservative programme: activity modification, specific physiotherapy, footwear and orthotic optimisation, and targeted injections when indicated. Surgery is reserved for cases where an appropriate non-surgical trial has genuinely failed.
How long does recovery take?+
Recovery depends on severity and treatment pathway. Simple cases settle in 2–6 weeks with conservative care. Surgical reconstruction typically follows a structured 3–6 month protected weight-bearing and rehabilitation programme, with return to sport around 4–6 months.
Will I need surgery?+
Not necessarily. Dr. Chandan Narang follows a strict conservative-first protocol. Surgery is offered only when imaging and clinical findings show that non-surgical care cannot restore function, or if there is structural damage that will worsen if left alone.
Can I avoid surgery if I follow physiotherapy properly?+
Often, yes — provided the physiotherapy is condition-specific (not generic), progressive, and combined with the right footwear, orthotics and activity modification. Many "failed physio" cases in fact never received the right protocol.
What happens if I delay treatment?+
Delay allows the underlying mechanical problem to progress: ligaments loosen further, cartilage wears down, deformity becomes rigid, and tendons tear. Reconstructive surgery for late-stage disease is bigger, longer and more expensive than early treatment.
Is this treatable through an online video consultation?+
Yes. Most flat foot cases can be reviewed via a structured video consultation with X-rays or MRI uploaded in advance. In-person examination is only required when a specific hands-on test is decisive.
What imaging will I need?+
Weight-bearing X-rays are the standard baseline. MRI is used for suspected soft-tissue tears, cartilage lesions or occult fractures. CT is reserved for complex bony deformity or trauma planning. Ultrasound is used selectively for dynamic tendon assessment.
Do I need to bring old reports and X-rays?+
Yes. Old imaging is invaluable for tracking progression. Please upload every prior report and image via WhatsApp before your consultation so Dr. Chandan Narang can review everything ahead of time.
Blogs & guides
Get an expert opinion on your flat foot — from anywhere in India.
Upload your X-ray or MRI in advance. Dr. Chandan Narang will review your case in a structured video consultation.