“Flat foot” means the arch under your foot is not high enough. This can be associated with the heel tipping outwards, the ankle tipping inwards and the whole foot can even swing outwards.

There are lots of causes for flat feet. Some people are born with flat feet and this may be totally normal for some people. Certain ethnic groups tend to be more likely to have flat feet which are completely normal for them and function normally. This is more common in women as women tend to have more stretchy ligaments and tendons which allows the foot to flatten to the floor. If the foot works well and doesn’t hurt, the shape doesn’t matter, this may be the way your foot was designed and be completely normal for you. In this instance, to surgically change the foot to a different shape would actually stop it working properly and would cause more damage.

Some people are born with one or two flat feet that are abnormal, and prevent the foot working normally. There may be a cause that can be corrected with insoles or surgery and in these instances, the function of the foot can be improved by correcting the shape.

In other cases a person may develop a flat foot over time, either after an injury to one of the ligaments, tendons or bones that holds the foot in the right shape, or it may occur spontaneously over a long time due to these same structures wearing out. If the foot is becoming sore, not working properly or you are worried it is collapsing more then you should visit your doctor.

Treatment for a flat foot depends on the cause. This may not require any treatment at all. It may require insoles, special footwear, physiotherapy, surgery, or a mixture of some or all of these.

Surgical treatment for flat foot may involve simple minor procedures, but often requires a full reconstruction. If the joints still move well then the foot can be corrected by reconstructing tendons and ligaments, along with cutting and moving some of the bones. If the flat foot has been present for a long time and the joints are stiff and arthritic then joints may need to be “fused” together. The surgery required is very bespoke to the exact cause, the shape of the foot and condition of the joints. An experienced foot and ankle surgeon will be able to assess your foot and xrays to decide exactly which operation would improve your foot shape.

After surgery you will be in a cast and will likely spend the night in hospital. You will need to spend two weeks with the foot elevated to minimise swelling. After two weeks you will need to have a review to check the wound has healed well and to remove the stitches. It is likely you will be ‘non weight bearing’ for several weeks (usually 6), often followed by a period in a protective boot (often another 6 weeks).

It is imperative you do not smoke or use an e-cigarette after surgery as this prevents healing and raises the risk of infection.