Adult Flatfoot Deformity Specialist

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Dr Poh Seng Yew



MMED (Ortho)



What is Adult Flatfoot?

Adult flatfoot, also known as adult-acquired flatfoot deformity (AAFD), is a condition characterised by the flattening of the arch in one or both feet. This is often accompanied by the foot turning outward. It results from various foot problems and can alter the alignment of the legs, potentially affecting the ankles and knees.

The lack of proper arch support in the foot can lead to overpronation, placing excess strain on the ankles and potentially leading to additional conditions like ankle instability and tendonitis.

Causes of Adult Flatfoot

Adult flatfoot can stem from several factors, each contributing to the weakening or alteration of the foot’s structure.

  • Posterior Tibial Tendon Dysfunction (PTTD)
    The posterior tibial tendon plays a role in stabilising the arch during walking. Inflammation or tearing of this tendon can result in a gradual collapse of the arch, leading to adult flatfoot.
  • Arthritis
    Arthritis, particularly in the foot, can lead to adult flatfoot. It affects not just the cartilage in the joints but also the ligaments supporting the foot, altering the foot shape and causing it to flatten.
  • Injury
    Injuries such as fractures in the midfoot bones or tears in the foot’s ligaments can disrupt joint alignment. This misalignment can contribute to the lowering of the foot arches, resulting in adult flatfoot.
  • Diabetes and Certain Nerve Conditions
    Individuals with diabetes or nerve problems that limit foot sensation may experience repetitive foot injuries. These injuries can lead to a severe collapse of the arch.

Symptoms and Signs

The manifestation of adult flatfoot can vary, with several symptoms indicating the presence of this condition.

  • Pain and Swelling on the Inside of the Foot and Ankle: One of the most common symptoms is pain and swelling, particularly on the inside of the foot and ankle. This discomfort often worsens with activities, making it challenging to walk or stand for extended periods.
  • Pain on the Outside of the Ankle: As the foot collapses and the heel bone shifts position, pressure can be exerted on the outside ankle bone. This can result in pain in this area.
  • Bony Bumps in the Midfoot: Patients who have had an injury or suffer from arthritis in the midfoot may develop painful, bony bumps on the top and inside of the foot.


The process of diagnosing adult flatfoot involves a combination of physical examination, imaging techniques, and medical review.

  • Medical Review: The foot and ankle specialist will review the patient’s medical history. This includes discussing any previous foot injuries, symptoms, and overall health conditions that may influence the development of adult flatfoot.
  • Physical Examination: A thorough physical examination is conducted to assess for signs of a flat arch. Patients might be asked to perform certain actions, such as standing on their toes or heels, to determine if an arch is visible when the foot is not bearing weight.
  • Imaging Tests: X-rays can be utilised to provide insights into the bone structure of the foot. It can also detect the presence of conditions like arthritis, which may contribute to the development of flatfoot.

Non-Surgical Treatment Options

Addressing adult flatfoot without surgery involves a range of methods, each tailored to the individual's specific needs and the underlying cause of the condition.

Assistive Devices

Foot and ankle specialists often recommend using foot tapings, braces, or shoe inserts (orthoses). These devices aim to correct flexible deformities and offload pressure points, providing support and alleviating discomfort.


Pain and anti-inflammatory medications are often prescribed to provide relief from symptoms. These can help manage pain and reduce swelling.

Physical Therapy

Patients can engage in physical therapy to strengthen and stretch the muscles and tendons in the feet. This can improve flexibility, mobility, and overall foot health.

Surgical Treatment Options

When non-surgical treatments for adult flatfoot are not effective, surgical intervention may be considered.

Reconstructive Procedures

Surgical options often involve reconstructive procedures, addressing both soft tissue (tendons, ligaments) and bony corrections. These surgeries aim to repair the underlying bone and tendon problems causing pain and dysfunction.

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Prevention Strategies

While not all cases of adult flatfoot can be prevented, certain measures can help reduce the risk or delay its progression.

  • Maintaining a Healthy Weight - Keeping a healthy weight reduces pressure on the feet, potentially lowering the risk of developing flatfoot or exacerbating existing conditions.
  • Supportive Footwear to Maintain Proper Foot Alignment - Choosing shoes that offer good arch support and cushioning can aid in maintaining proper foot alignment. In some cases, custom orthotic inserts may provide additional support.
  • Exercises to Strengthen the Feet - Regular exercises that strengthen and stretch the feet can improve arch support and overall foot health.
  • Avoiding High-Impact Activities - Engaging in activities that avoid excessive stress on the feet, especially for individuals with a family history of flatfoot or other foot-related issues, can be beneficial.

Dr Poh Seng Yew



MMED (Ortho)


With over 20 years of experience, Dr Poh Seng Yew is an orthopaedic surgeon specialising in hip, knee, shoulder and elbow surgery, sports medicine, and trauma surgery.

  • Former Director of Sports Service, Department of Orthopaedic Surgery, Singapore General Hospital
  • Clinical Hip and Sports Medicine Fellow, Orthopädische Chirurgie München (OCM), Germany
  • Fellow, Royal College of Surgeons of Edinburgh, FRCSEd (Orthopaedic Surgery)
  • Master of Medicine (Orthopaedic Surgery), National University of Singapore
  • Member, Royal College of Surgeons of Edinburgh (MRCSEd)
  • Bachelor of Medicine, Bachelor of Surgery (MBBS), National University of Singapore



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Mount Elizabeth Novena Specialist Centre
38 Irrawaddy Road, #08-62/63
Singapore 329563

Weekdays: 9.00am – 5.00pm
Saturdays: 9.00am – 1.00pm
Sundays and Public Holidays: Closed

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    Mount Elizabeth Novena Specialist Centre
    38 Irrawaddy Road, #08-62/63
    Singapore 329563

    Frequently Asked Questions (FAQ)

    What Exercises Can Help Treat Flat Feet?

    Exercises focusing on strengthening and stretching the muscles and tendons in the feet can be beneficial. These might include calf stretches, arch lifts, and toe curls. Regular practice of these exercises, along with guidance from a foot and ankle specialist, can improve foot health and alleviate symptoms of flatfoot.

    Can Walking Barefoot Help Flat Feet?

    Walking barefoot, particularly on varied surfaces, can help strengthen the muscles in the feet. Balance this with wearing supportive footwear, especially if you are experiencing pain or discomfort. A foot specialist can provide personalised guidance on the best approach for each case.

    What Happens If Adult Flatfoot Is Left Untreated?

    Untreated adult flatfoot can progress, potentially leading to increased discomfort and further complications in foot function. It can contribute to issues such as ankle problems, knee conditions, lower back pain, and the development of conditions like shin splints and plantar fasciitis. Seek guidance from a foot and ankle specialist for timely treatment and effective management strategies.