FLAT FEET
Flat Feet Treatment in Billings, MT
Flat feet can cause pain throughout your body — from your feet to your knees, hips, and back. We identify the cause and develop a treatment plan that works.
What Are Flat Feet?
Flat feet, or pes planus, is a condition where the normal arch of the foot is reduced or absent, allowing the entire sole to make contact with the ground during standing. While many people with flat feet experience no symptoms at all, the condition can cause significant pain and functional limitations when the loss of arch support affects foot mechanics and lower limb alignment.
There are two main types:
- Flexible flatfoot — The arch disappears when standing but reappears when you sit or stand on your toes. This is the most common type and is often inherited. It may or may not cause symptoms.
- Rigid flatfoot — The arch is absent regardless of position. This can be caused by tarsal coalition (bones fused together), arthritis, or severe posterior tibial tendon dysfunction. Rigid flatfoot is more likely to cause pain and may require surgical intervention.
When Flat Feet Become a Problem
Foot & Arch Pain
Aching pain along the inner ankle and arch, especially after prolonged standing, walking, or exercise. The posterior tibial tendon along the inner ankle often becomes inflamed and painful.
Lower Leg Pain
Shin splints, calf tightness, and Achilles tendon strain from the altered mechanics of walking with collapsed arches. The ankle rolls inward excessively with each step.
Knee, Hip & Back Pain
The chain reaction from flat feet travels upward. Internal rotation of the leg bones places abnormal stress on the knee ligaments, hip joints, and lumbar spine.
Difficulty with Activity
Fatigue during standing, reduced endurance during walking or running, difficulty with balance, and inability to stand on tiptoes on one foot (indicating posterior tibial tendon weakness).
Flat feet causing you pain?
Schedule an evaluation →Flat Feet Treatment Options
Custom Orthotics
Custom orthotics are the cornerstone of flat feet treatment. We take a mold or digital scan of your foot and prescribe an orthotic device designed to:
- Support the arch at the exact height and position your foot needs
- Control excessive pronation (inward rolling) during walking and running
- Redistribute pressure to reduce strain on the posterior tibial tendon
- Correct asymmetries between your left and right feet
- Fit into your everyday shoes, work boots, and athletic footwear
For many patients, custom orthotics combined with supportive shoes are all that is needed to eliminate symptoms and maintain an active lifestyle.
Physical Therapy & Strengthening
- Posterior tibial tendon strengthening — Exercises that target the primary dynamic arch supporter of the foot
- Intrinsic foot muscle training — Short-foot exercises and toe curls that build the small muscles within the foot itself
- Calf stretching — Tight calves worsen flat foot mechanics. Regular stretching reduces compensatory strain
- Ankle stability work — Balance and proprioceptive exercises that improve foot and ankle control
Surgical Reconstruction
For severe flatfoot deformity that does not respond to conservative treatment, or for rigid flatfoot caused by structural abnormalities, our surgeons perform comprehensive flatfoot reconstruction:
- Posterior tibial tendon repair or transfer — Restoring the function of the primary arch-supporting tendon
- Calcaneal osteotomy — Shifting the heel bone to correct alignment and restore the arch
- Lateral column lengthening — A bone graft procedure that restores the arch by lengthening the outer column of the foot
- Arthrodesis (fusion) — For the most severe cases, selective joint fusions stabilize the foot in a corrected position
Flatfoot reconstruction is a complex surgery that our board-certified surgeons perform at Yellowstone Surgery Center, with a structured post-operative rehabilitation plan.
Why Choose Rimrock Podiatry for Flat Feet?
Biomechanical Expertise
Flat feet are a biomechanical problem, and our podiatrists perform detailed gait analysis and biomechanical evaluation to understand how your flat feet affect your entire body.
Custom Orthotic Prescription
We prescribe and fit custom orthotics based on molds of your feet, not generic inserts. Each device is designed for your specific foot structure and activity needs.
Reconstructive Surgery
For severe cases, our surgeons have the training and experience to perform complex flatfoot reconstruction — restoring arch height, correcting alignment, and maintaining mobility.
Pediatric Experience
If your child has flat feet, we can evaluate whether monitoring, orthotics, or intervention is appropriate. Most childhood flat feet are normal, but some need attention.
Frequently Asked Questions About Flat Feet
Do flat feet always need treatment?
No. Many people have flat feet that cause no pain or functional problems and require no treatment at all. Treatment is indicated when flat feet are causing symptoms — foot pain, ankle pain, knee pain, hip pain, shin splints, fatigue during standing or walking, or difficulty with athletic activities. If your flat feet are not causing problems, periodic monitoring is appropriate.
Can flat feet be corrected in adults?
Flexible flat feet in adults can be effectively supported with custom orthotics, which control the foot position and reduce symptoms. Strengthening exercises for the posterior tibial tendon and intrinsic foot muscles can also improve arch support. For severe flatfoot deformity, surgical reconstruction can restore the arch and realign the foot. The specific approach depends on the severity and rigidity of the deformity.
Do children outgrow flat feet?
Most children have flat feet until around age 5 to 6, when the arch typically develops. About 1 in 5 children will not develop an arch and will have flexible flat feet into adulthood. In most cases, childhood flat feet are painless and require only monitoring. Treatment is considered if the child has pain, difficulty with activities, abnormal shoe wear, or a rigid flatfoot that cannot form an arch when standing on tiptoes.
What is the difference between custom orthotics and store-bought insoles?
Store-bought insoles provide generic arch support based on shoe size. Custom orthotics are prescribed medical devices molded from a cast or scan of your foot, designed to control your specific biomechanical abnormalities. Custom orthotics address the exact point where your foot needs support, the degree of correction required, and any structural asymmetries between your feet. For flat feet causing pain, the difference in effectiveness is significant.
Can flat feet cause knee or back pain?
Yes. Flat feet alter the alignment of the entire lower limb. When the arch collapses, the ankle rolls inward (overpronation), which rotates the shin and thigh bones internally. This altered alignment places abnormal stress on the knees, hips, and lower back. Many patients with chronic knee or back pain find that addressing their flat feet with proper orthotics resolves or significantly reduces their upper body symptoms.
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Our board-certified podiatric surgeons will evaluate your condition, explain your options, and create a treatment plan tailored to your needs.