Treatment Methods for Flat Foot (Fallen Arch)

Flat foot is the most common foot condition seen today, occurring when the foot's arch collapses so that nearly the entire sole makes contact with the ground, often accompanied by knock-knees, misaligned limb axes, and poor balance. A typical case at the clinic was a 12-year-old boy with significant flattening and arch collapse in his left foot, along with inward rotation of the leg and knee; this caused his pelvis to tilt, made his legs appear unequal in length even though the bones were actually the same length on both sides, and had already begun affecting his spine, contributing to scoliosis.

Young children are typically born with physiologically flat feet; the arch begins forming as they learn to stand, crawl, and walk, developing most noticeably between roughly ages 2 and 5. For children with mild arch collapse at this age, exercises specifically for flat feet to stimulate movement and ligament development are often enough to let the arch form naturally. However, for more significant arch collapse, cases where the foot's structure cannot push the arch up on its own, or children over age 5, intervention with an arch-supporting orthotic insole becomes necessary; even beyond age 8, when the potential for arch improvement is limited, an insole is still worth considering to prevent further collapse and limit downstream effects on the hips, pelvis, and spine.

There are currently three treatment approaches for flat feet, each with its own trade-offs. The first is daily flat-foot exercises, suitable for children under 5 with mild arch collapse — simple and cost-free but requiring persistence. The second, and most commonly chosen, is a custom orthotic insole placed inside footwear to support the arch and realign the limb axis and pelvis; this method is easy to use, safe, painless, and can be paired with supportive exercises. The third is surgery to fix the ankle bones with screws, which should only be considered when conservative methods have failed, given the risk of infection, a 6–8 week recovery period, and the possible need for a cast afterward.

The insole treatment process at the clinic typically begins with a thorough examination, followed by measuring, scanning, or plaster-casting the foot to produce an insole matched precisely to each patient's foot shape. Based on the clinic's clinical experience, regular use of orthotic insoles helps improve flat-foot conditions, supports a more balanced standing and walking posture, and contributes to preventing complications related to the spine and knee joints by aligning the body's posture starting from the foot upward — though the specific outcome for each case should always be confirmed through periodic follow-up examinations.