Flat Feet

Flat Feet Correction in St. Louis and Chesterfield

Navigating Flat Feet:

A Comprehensive Guide

Flat feet, characterized by fallen arches, can be more than just an anatomical trait; they may cause discomfort or pain. Our podiatry center specializes in identifying and treating the nuances of flat or misaligned feet, considering individual symptoms and structural differences.

We employ meticulous diagnostic methods, including hands-on evaluations and state-of-the-art imaging, to pinpoint specific issues. Our approach to management ranges from conservative measures like custom orthotics and tailored physical therapy regimens, to advanced surgical interventions such as the HyProCure stent procedure when indicated. Learn more about your specific type of flat foot condition and treatments available here.

Adapting lifestyle choices plays a pivotal role too. We guide you through effective strategies to reduce symptoms, such as selecting proper footwear, modifying activities, and maintaining a healthy weight.

Your journey to improved foot health and mobility starts with Feet for Life. Our physicians are on the forefront of advances and treatments for this condition. If you are experiencing pain or tendencies to limit activity because of flat feet, get help from our experienced physicians today.

Request your initial appointment here or, if you are a potential outside of St. Louis, Missouri, you may request a virtual consultation here.

Must Know About This

  • Flat arches in children usually become proper arches, especially if the child goes barefoot on varying terrain to stimulate muscular growth and coordination.
  • Wearing shoes, especially supportive shoes, can prevent a normal arch from developing, and orthotics, both custom-made and over-the-counter, can cause further weakening.
  • Studies indicate that, not only do flat feet have no impact on physical functioning, but that soldiers with high arches were much more likely to suffer injuries than those with flat feet.

Good to Know About This

  • Most flexible feet are asymptomatic and considered a normal human variant, although problems can develop if intrinsic foot muscles are especially weak.
  • “Fallen arches”, as opposed to hereditary flat feet, is a condition caused by progressive weakening of the feet over time.
  • A “rigid flatfoot” can cause significant bio-mechanical problems, but a “supple flatfoot” should present no problems, as long as the muscular integrity of the arch is preserved by allowing the foot to work without external support.

Today is the day to find relief from your foot pain. Contact us now to get started!

More About This

The term adult acquired flatfoot is more appropriate because it allows a broader recognition of causative factors, not only limited to the posterior tibial tendon, an event where the posterior tibial tendon looses strength and function.

The adult acquired flatfoot is a progressive, symptomatic (painful) deformity resulting from gradual stretch (attenuation) of the tibialis posterior tendon as well as the ligaments that support the arch of the foot.

Most flat feet are not painful, particularly those flat feet seen in children. In the adult acquired flatfoot, pain occurs because soft tissues (tendons and ligaments) have been torn. The deformity progresses or worsens because once the vital ligaments and posterior tibial tendon are lost, nothing can take their place to hold up the arch of the foot.

The painful, progressive adult acquired flatfoot affects women four times as frequently as men. It occurs in middle to older age people with a mean age of 60 years. Most people who develop the condition already have flat feet. A change occurs in one foot where the arch begins to flatten more than before, with pain and swelling developing on the inside of the ankle. Why this event occurs in some people (female more than male) and only in one foot remains poorly understood. Contributing factors increasing the risk of adult acquired flatfoot are diabetes, hypertension, and obesity.

The following scheme of events is thought to cause the adult acquired flatfoot:

A person with flat feet has greater load placed on the posterior tibial tendon which is the main tendon unit supporting up the arch of the foot. Throughout life, aging leads to decreased strength of muscles, tendons and ligaments. The blood supply diminishes to tendons with aging as arteries narrow. Heavier, obese patients have more weight on the arch and have greater narrowing of arteries due to atherosclerosis. In some people, the posterior tibial tendon finally gives out or tears. This is not a sudden event in most cases. Rather, it is a slow, gradual stretching followed by inflammation and degeneration of the tendon. Once the posterior tibial tendon stretches, the ligaments of the arch stretch and tear. The bones of the arch then move out of position with body weight pressing down from above. The foot rotates inward at the ankle in a movement called pronation. The arch appears collapsed, and the heel bone is tilted to the inside. The deformity can progress until the foot literally dislocates outward from under the ankle joint.

There are three stages of the adult acquired flatfoot:

Stage I: Inflammation and swelling of the posterior tibial tendon around the inside of the ankle.

Stage II: Visible deformity comparing one foot to the other, as the symptomatic foot becomes flatter and more deformed. The deformity is movable and correctable in this stage.

Stage III: The foot progresses to a rigid, non-movable flat foot deformity that is painful, primarily on the outside of the ankle.


The adult acquired flatfoot, secondary to posterior tibial tendon dysfunction, is diagnosed in a number of ways with no single test proven to be totally reliable.

The most accurate diagnosis is made by a skilled clinician utilizing observation and hands on evaluation of the foot and ankle. Observation of the foot in a walking examination is most reliable. The affected foot appears more pronated and deformed compared to the unaffected foot. Muscle testing will show a strength deficit. An easy test to perform in the office is the single foot raise.

A patient is asked to step with full body weight on the symptomatic foot, keeping the unaffected foot off the ground. The patient is then instructed to “raise up on the tip toes” of the affected foot. If the posterior tibial tendon has been attenuated or ruptured, the patient will be unable to lift the heel off the floor and rise onto the toes. In less severe cases, the patient will be able to rise on the toes, but the heel will not be noted to invert as it normally does when we rise onto the toes.

X-rays can be helpful but are not diagnostic of the adult acquired flatfoot. Both feet – the symptomatic and asymptomatic – will demonstrate a flatfoot deformity on x-ray. Careful observation may show a greater severity of deformity on the affected side.

Today is the day to find relief from your
foot pain. Contact us now to get started!

Schedule Your Appointment

Call us: 314-207-7280

Feet for Life Podiatry Centers are one of the top-ranked foot and ankle practices in the Midwest, specializing in both surgical and nonsurgical procedures to relieve your pain and give you beautiful, functional feet with minimal downtime or discomfort.


Dr. Horwitz is
Available for
Virtual Consultations

85 percent of our out-of-town patinets choose this convenient way to consult about their foot condition. Receive a world-class consultation from the top podiatric surgeon with over 35 years of surgical experience.

Get started NOW!Schedule Now

Virtual Consultation
with Dr. Horwitz