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You probably don't give much thought to the steps you take. However, walking is actually quite a complex act, especially for your feet. Because your feet support all of your weight and help you balance when you stand, they're subject to substantial pressure and risk of injury.

One foot condition is flatfeet (pes planus). If you have flatfeet, the arch on the inside of your feet is flattened. Flatfeet usually doesn't cause a problem. However, flatfeet can contribute to problems in your feet, ankles and knees. Simple corrective devices are available to help prevent complications of flatfeet.

With flatfeet, you may experience the following signs and symptoms:

• A flat look to one or both of your feet
• Uneven shoe wear and collapse of your shoe toward the inside of your flat foot
• Lower leg pain or weakness
• Pain on the inside of your ankle
• Swelling along the inside of your ankle
• Foot pain

Your feet are highly specialized structures. Each foot is made up of 26 bones held together by 33 joints and more than 100 muscles, tendons and ligaments. The intricate alignment of these structures results in the formation of your arches.

As you walk, these springy, elastic arches help distribute your body weight across your feet and legs. Your arches also play an integral role in how you walk. They act as rigid levers for proper mobility, but they must also be resilient and flexible to adapt to various surfaces.

Not all feet are the same
Flat feet are normal in infants and toddlers, because the foot's arch hasn't yet developed. Most people's arches develop throughout childhood, but some people never develop arches. This is a normal variation in foot type, and people without arches may or may not have problems.

Lax ligaments can cause flatfeet, as can conditions present at birth (congenital) that affect the foot.

Arches can also fall over time. Years of wear and tear can weaken the posterior tibial tendon, which runs along the inside of your ankle, from above your ankle to your arch. The posterior tibial tendon is the main support structure for the arch. An overload to this tendon can cause inflammation of the tendon (tendinitis) and even tearing of the tendon. Once the tendon is damaged the foot's arch loses support and can flatten.

You may lose support in your arches due to:

• Ongoing stresses in your feet. One of these stresses may be long-term wearing of high heels, which can affect your Achilles tendon and change the mechanics of your ankles. Compensation by the posterior tibial tendon may eventually cause it to break down and your arches to fall.
• Obesity.
• Traumatic injury to your foot or ankle.
• Rheumatoid arthritis.
• Diabetes.

Your doctor will consider your medical history and examine your feet. As part of the examination, your doctor will observe your feet from the front and the back and ask you to stand on your toes so he or she can view the mechanics of your feet.

To view the interior structure and bones of your foot, your doctor may request an imaging test of your foot, which may include an X-ray, a computerized tomography (CT) scan or a magnetic resonance imaging (MRI) scan.

Flatfeet may contribute to or worsen other foot problems, including:

• Inflammation and pain in the ligaments in the soles of your feet (plantar fasciitis)
• Achilles tendonitis and posterior tibial tendinitis
• Shin splints
• Stress fractures in your lower leg
• Bunions
• Calluses

Because flatfeet can affect your body's alignment, the condition may also lead to pain in your ankles, knees and hips.

In many people flatfeet doesn't cause problems. It may be that the lower parts of your legs have aligned in such a way as to accommodate for flatfeet. If so, you may not have any pain or other problems.

If the disorder is causing you problems, you may be able to reduce foot pain by wearing over-the-counter insoles or arch supports. Ask your doctor whether these are appropriate for you.

Your doctor may suggest these other treatments and adjustments, depending on your condition:

• Custom-designed arch supports. Commonly called foot orthotics, these are interchangeable among your shoes and may provide more support because they're molded to the contours of your feet. Orthotics come in three types: rigid, semirigid and soft. The type that's right for you depends on what kind of support your doctor is trying to provide to your feet.
• Rest. Your doctor may recommend rest and avoiding activities that may aggravate your condition until your foot feels better.
• Medications. Your doctor may suggest you take over-the-counter pain relievers until the pain subsides.
• Weight loss. If you're overweight, losing weight may help.
• Wedge, in addition to an orthotic. If you have tendinitis of the posterior tibial tendon, you may need to insert a wedge along the inside edge of the orthotic to take some of the load off the tendon tissue.
• Additional foot support. Your doctor also may advise that you wear an ankle brace or a walking boot for a time until the tendon inflammation subsides.
• Surgery. In severe cases, you may need tendon surgery.

Depending on the diagnosis and on the severity of your foot or lower leg symptoms, your doctor may advise you to limit your weight-bearing activities while wearing walking boots or orthotics. This gives time for the swelling and pain in your feet to subside and allows your feet to regain their full range of motion.

Once your symptoms have subsided, you may find that you can return to normal activities, including exercise. However, nonweight-bearing exercise, such as cycling and swimming, may still be best, especially when you first get back to activity. In addition, your doctor may advise continued use of orthotics while walking.