What are collapsed arches?

Collapsed arches, also known as flat feet or fallen arches, occur when your foot has little or no arch at the midpoint of the feet. Feet with an arch use several tendons in the foot and leg to form and support the arch in the food. Collapsed arches appear when those tendons are not forming the right tension. When walking, people with collapsed arches walk with their whole sole touching the floor instead of just the ball of the foot and the heel. 

Arches form as you develop through childhood as all babies are born with flat feet. For some people, however, arches do not develop, leaving the person with flat feet. For others, they may develop normal arches throughout childhood, but they may experience collapsed arches later in life. One or both feet can have collapsed arches as the tendons supporting the arch get damaged or become worn over time. Typically, collapsed arches are not a cause for concern and are treatable with physical therapy and supportive devices. In addition, collapsed arches are fairly common, affecting 25% to 30% of adults.

What causes collapsed arches?

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Collapsed arches occur over time and have many possible causes including other medical conditions and genetic predisposition. The arches fall when the tendons forming the arch wear out or are damaged in an injury. When arches fail to form through childhood, the flat feet appear to be congenital and related to one’s genes. 

In addition to trauma-related causes of collapsed arches such as damage to the posterior tibial tendon (PTT) or Achilles tendon, underlying medical conditions may also contribute to the cause of collapsed arches. Conditions such as diabetes, obesity, plantar fasciitis, and arthritis all can cause the foot to gradually lose its arch. Also, heredity conditions like Ehler-Danlos syndrome and Marfan syndrome, which impact tendons and ligaments, can play a role.

What are the symptoms of collapsed arches?

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The symptoms of collapsed arches vary for each person, and some people with collapsed arches may not experience symptoms at all. Symptoms could develop or worsen with time, which should signal a trip to your primary care physician to discuss your diagnosis and treatment options. 

You may experience the following symptoms if you have collapsed arches:

  • Feelings of fatigue in the feet that with a quick onset
  • Leg and back pain and cramps 
  • Pain when standing on your feet for periods of time 
  • Swollen foot soles 
  • Persistent aches and pains in the arches or heels 
  • Changes in your walking gait 
  • Limited foot mobility 
  • Feeling unbalanced when standing 
  • Visible lack of an arch or a noticeable decrease in your normal arch
  • Changes in the location, direction, and flexibility of the toes

Symptoms can affect one or both feet at a time. Typically, once symptoms of collapsed arches start, they can worsen with activity. 

Are there any risk factors or groups for collapsed arches?

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There are several risk factors that may increase your chances of being born with flat feet or developing collapsed arches in your lifetime. The risk factors include heredity, medical history, and demographics.

You may be at a higher risk of developing collapsed arches if you meet one or more of the following risk factors. 

Age: As you age, you are at a higher risk of collapsed arches partly because of the other conditions that are more likely as you age, such as arthritis. Also, aging tends to make your tendons and ligaments tighter and susceptible to injury and wear. 

Family history: You are more likely to have collapsed arches if someone in your family also has collapsed arches. Collapsed arches can be congenital, meaning it is present at birth, because of your foot anatomy or genetics. 

Medical conditions: Certain medical conditions put you at a higher risk of collapsed arches. The most common medical conditions that lead to collapsed arches are obesity, diabetes, arthritis, cerebral palsy, high blood pressure, and pregnancy.

Injury and overuse: Traumatic injury to your feet, calves, and legs can all contribute to a higher risk of collapsed arches. If the PTT that connects your calf to the foot is injured, the injury might be sufficient enough to lead to the gradual collapse of the arch. Overuse of the tendons and ligaments in the legs and feet can have a similar effect on the arches and can increase your chances of collapsed arches. 

How are collapsed arches diagnosed?

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To diagnose collapsed arches, you will need to see your primary care physician or a podiatrist who will review your feet, symptoms, and health history. The aim of a diagnosis is to confirm that you have collapsed arches and what might have caused them to collapse. Since collapsed arches can affect one or both feet, your doctor will carefully examine both feet to determine which are affected. 

A review of your health history will identify previous injuries or medical conditions, which may have caused the collapsed arches or may put you at a higher risk of the condition. Your doctor will likely review your symptoms and ask how long you have been experiencing foot pain or any changes in your feet. 

After a review of your health history, the doctor may conduct a physical examination of the feet and observe your feet as you perform certain movements and walk across the room. These examinations will help the doctor assess the strength of the feet and legs and notice any abnormalities in your gait or foot structure. 

While the doctor or podiatrist can likely confirm a collapsed arches diagnosis with a review of your health history and a physical examination, sometimes imaging tests can be useful to determine the cause of the collapse and diagnose other conditions. Imaging tests could include the following: 

  • X-ray
  • CT scan
  • Ultrasound
  • MRI 

How are collapsed arches treated?

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Treatment for collapsed arches is determined on a case-by-case basis since your individual symptoms will inform what types of treatment to explore. In many cases, collapsed arches need no treatment if there are no adverse effects that get in the way of your daily life. While for others, treatment is needed to alleviate pain and restore strength and mobility. 

There are both surgical and non-surgical treatments that help manage the symptoms of collapsed arches. 

Orthotic devices: Arch support devices like shoe inserts can mold to your foot and provide a great deal of support in your everyday shoes. Orthotic devices can relieve symptoms and stabilize your feet and ankles.  

Physical therapy: Physical therapy might benefit people with collapsed arches to have professional help to stretch and strengthen the tendons in the foot and legs. Physical therapy cannot reverse a collapsed arch, but it can help people adjust to their new normal. 

Steroid injections: Injected medications such as corticosteroids are a temporary measure to reduce inflammation in the joints to help relieve some of the pain associated with walking. 

Home remedies: Resting and icing the feet are effective home remedies to give your feet a break to reduce overuse and swelling. Over-the-counter pain relievers address the discomfort from a long day on your collapsed arches while supportive shoes can help cushion your feet and help you walk better.  

Surgery: Surgery may be necessary to treat collapsed arches if there are issues beyond collapsed arches. Surgical options to treat collapsed arches and related foot issues include bone fusions, bone reshaping, cleaning tendons, and bone or tendon grafts.

Should you see a doctor for collapsed arches?

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You should see a doctor for collapsed arches to receive a proper diagnosis and if you are in significant pain. Seeking a podiatrist who specializes in foot conditions is a good option to receive more specialized treatment. Leading up to your appointment, you can keep track of your symptoms and be sure to bring the shoes you wear most often so that your doctor has the chance to review your walking pattern. 

Call a doctor if you begin to experience extreme pain in your feet, very sudden changes in the appearance of your foot or feet, or difficulty with balance and walking. You should not ignore symptoms of collapsed arches as they could worsen without the right medical intervention.

What is the outlook for people living with collapsed arches?

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While there are no preventative measures for collapsed arches, there are ways to manage collapsed arches that make the outlook living with collapsed arches positive. Some people may be able to rely on home remedies to take care of their feet while others may not need any treatment. If treatment is necessary, the non-surgical and surgical treatments are typically effective at addressing your symptoms. 

Having collapsed arches can increase your risk of developing other problems like bone spurs, bunions, shin splints, or radiating pain in the back, hips, or knees. It is important to address symptoms as they arise to limit damage to other areas of your body and maintain a good quality of life. Understanding your risk for collapsed arches and your risk for related conditions can aid in your ability to detect these conditions early on and seek medical attention.