The shape of an adult flat foot generally cannot be changed without surgery, but the pain associated with it usually can be managed well without one. Treatment aims to reduce the load on the tissues that hurt, using footwear, strength work and orthotic support. Many people become fully comfortable and active while still having low arches, because comfort depends on load tolerance rather than arch height.

Often, yes. Foot structure, ligament flexibility and bone alignment are strongly influenced by genetics, so flat feet frequently appear across several family members. That does not mean pain is inevitable. Plenty of people with an inherited low arch never develop symptoms. Knowing there is a family history is useful, because it helps your podiatrist judge whether your foot shape is long-standing or something that has changed recently.

Most children develop a visible arch between the ages of four and six, and the process can continue into the early teens. Flat feet in toddlers are normal and expected, because the arch is filled with fat pad and the joints are still flexible. Worth reviewing sooner: pain, tripping, unwillingness to walk distances, or one foot looking clearly different from the other.

They can contribute. When the foot rolls inwards further or for longer than usual, the shin bone rotates inward with it, which changes how the knee and hip joints load. That extra rotation can irritate structures well away from the foot. Flat feet are rarely the only cause, so your podiatrist tests whether supporting the foot actually changes your knee or back symptoms before committing to long-term treatment.

Usually yes. Most Australian services assess whether your feet are painful and functional rather than whether you have an arch, so asymptomatic flat feet are commonly accepted. Rigid flat feet, tendon problems or ongoing pain are more likely to be queried. [CONFIRM: whether OnePointHealth provides pre-employment podiatry reports and assessments for defence and emergency services applicants]

An arch that drops in adulthood usually means the tendons and ligaments holding it up have lost the ability to do so. The tibialis posterior tendon is the most common culprit, and pregnancy, weight change, inflammatory arthritis and diabetes all raise the risk. A new asymmetry between your feet is worth assessing promptly, because early support tends to work better than late support.