From the Research
No, feet are not truly flat if arches appear when standing on tip toes, as this indicates the presence of flexible flatfoot, where the arch collapses during weight-bearing but can still form when not under load. This distinction is crucial because flexible flatfoot is generally less concerning and often doesn't require treatment unless causing pain or functional problems 1. The appearance of an arch on tip toes demonstrates that the foot's structural components for arch formation are present but may lack sufficient strength or support during normal standing.
Key Considerations
- Flexible flatfoot often resolves naturally with growth as foot muscles strengthen in children.
- For adults with symptomatic flexible flatfoot, treatment might include supportive footwear, custom orthotics, physical therapy exercises to strengthen foot muscles, or in severe cases, bracing or surgery 2, 3.
- A recent study found that exercise and foot orthoses can reduce pain in adult flatfoot, but may not realign foot posture 1.
- The size of the graft used for the Cotton osteotomy was significantly associated with changes in the cuneiform articular angle, suggesting that this procedure can be effective in correcting longitudinal arch collapse in stage IIb adult-acquired flatfoot deformity 3.
Diagnostic Considerations
- Weightbearing plain radiography or computed tomography (CT) is used for diagnosis or treatment selection in foot disorders, and recent studies have compared foot alignment between full weightbearing and nonweightbearing or partial weightbearing conditions 4.
- The lateral talometatarsal angle and calcaneal pitch angle were found to be strongly correlated between full weightbearing plain radiographs and non- or partial weightbearing CT scans, suggesting that these imaging modalities can provide similar information about foot morphology 4.