Flexible Flatfoot (Pes Planus)

What is a Flexible Flatfoot?

Understanding the condition

Flexible flatfoot, also known as pes planus or flexible flatfoot (pes planus), is a common condition affecting flat feet in children. In this condition, the low foot arch or fallen arches become more noticeable when the child is standing but typically reappear when sitting or standing on tiptoes. Flexible pes planus is usually painless and considered a normal part of development. However, some children with child flat feet or pediatric flatfoot may develop overpronation with an inward ankle roll, leading to tired feet, children’s foot pain, discomfort, or difficulty with physical activity. Early flexible flat foot treatment can help relieve symptoms when they occur.

When to suspect a Flexible Flatfoot?

Signs & Symptoms

Low or absent arch when standing

Tired or achy feet/legs after activity

Inward ankle roll (over-pronation)

How We Diagnose Flexible Flatfoot

Diagnosis of flexible flatfoot (pes planus) begins with a thorough physical examination to evaluate the low foot arch, fallen arches, and arch appearance in both standing and tiptoe positions. Dr. Malek Abu Al Nadi assesses gait, overpronation, inward ankle roll, foot alignment, and Achilles tendon tightness to determine the severity of pediatric flatfoot.

Imaging is usually not required; however, X-rays may be recommended if children’s foot pain, stiffness, or another underlying condition is suspected. This comprehensive assessment helps guide the most appropriate flexible flat foot treatment plan for children.

How are is a Flexible Flatfoot treated?

How We Heal a Flexible Flatfoot

Observation – Most cases improve naturally as the arch develops with age
Supportive footwear or custom orthotics – Used when there is pain or activity limitation
Stretching exercises – Especially for a tight Achilles tendon
Activity modification – Adjusting sports or intensity if symptoms flare
Weight management – When excess weight contributes to discomfort

How is surgery performed?

Surgery is rarely needed. For persistent, symptomatic cases that don’t improve with conservative care, procedures may include soft-tissue lengthening (e.g., Achilles), bone realignment procedures (such as calcaneal osteotomy), or arthroereisis (a small implant to support the arch). Dr. Malek Abu-Al-Nadi recommends surgery only when clearly necessary, with a priority on conservative care first.e

We ARE Specialized in foot & ankle health

Expert Care You Can Trust

At The Modern Podiatry, Dr. Malek Abu Al Nadi combine advanced diagnostics, evidence-based treatments, and personalized rehabilitation plans to ensure a safe and complete recovery for ankle sprains.