You may hear your doctors talking about a tarsal coalition – this is just another way of saying that the bones have not separated. The small bones of the foot (tarsals) do not separate properly. In children the foot may not develop normally in the womb. The causes differ in children and adults. Such feet are said to be “pathological” – which just means abnormal. You should try to buy shoes with an arch support and a well-constructed, supportive heel.Ī small number of people have flat feet, which are a problem. Shoes tend to wear out more quickly in people with flat feet, but simply wearing comfortable shoes is the best initial treatment. If you have physiologically flat feet you can be reassured that there is no structural abnormality needing treatment. People with physiologically flat feet often have stretchy ligaments (hypermobility). When you stand on tiptoes the arch of the foot re-establishes. The arch is flattened, but the foot is supple and pain free. The commonest cause of a flat foot is the so-called “physiological flat foot.” This means that the flatness is a variation of normal. The vast majority of flat feet fall into this group. In these situations you may choose to seek medical help.
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