Flexible pes planovalgus (flatfoot) is a common condition that should be treated when it is associated with pain. 1 A flatfoot in its simplest terms is defined as collapsing of the foot, resulting in loss of arch height. Flexible flatfoot differs from rigid flatfoot in that a rigid flatfoot is permanently fixed in the flat position. A flexible flatfoot is only made flat when weight is put onto the foot during standing or walking. It is important to differentiate the two forms of flatfoot (flexible vs rigid) because the management of the conditions is markedly different. Flexible flatfoot, in general, is considered to be a less severe condition. Luckily, the majority of people who have flat feet do not experience pain, discomfort or any other physical limitations. Unfortunately, pes planus cannot be prevented, but it can be managed. The reason why some people develop it and others do not, is still a mystery. It has been suggested that there may be a genetic link, but at this time it is still unknown. in patients with talonavicular subluxation, consider taking a wt bearing AP of the patients feet with and without the inserts; flexible flatfeet are asymmetic for most pts, & its impossible to predict which planovalgus feet will become painful in adulthood; When there is no pain, someone with flat feet can largely go untreated. Pain in the foot, knees or lower back is an indication that treatment may be necessary. Orthotics may be required and worn for life. If the condition is less severe, arch supports can be purchased at a local drugstore. Some doctors also recommend various foot exercises. In children, these exercises (sometimes as simple as going barefoot on a rocky beach) can strengthen the muscle and help to form or reform the arch so that overtime the feet become normal. This reformation of the arch is much more difficult to accomplish with adults who have fallen arches. With failure of conservative treatment, surgery may be recommended. Surgery should be directed at the underlying pathology including tendon repair, tendon transfer, bony realignment (or osteotomy), and occasionally fusion of bones. If surgery is performed, frequently an arch will be rebuilt in the foot to prevent recurrence of symptoms. Afternoon PEB forum from yokosuka,japan! I speak for everyone when I say I appreciate what you guys do on this website it really helps everyone out with conditions of all sorts; for both senior and junior enlisted/officer. Great job to each and everyone one of you! When able to start training again, analyze your program and identify and fix any training errors that might contribute to your problem. Identify and address any muscle inflexibilities and weaknesses that may contribute to excessive pronation and poor mechanics. This includes the local muscles of the foot and ankle as well as those of the thigh and hip because excessive hip adduction and internal rotation of the thigh contributes to excessive pronation of the foot. This kind of knee discomfort is called patellofemoral pain, and is also known as patellofemoral pain syndrome. It's also commonly referred to as chondromalacia, but you'll soon see why these two terms are not interchangeable.