Reducing pain from flat feet may involve incorporating some changes in your daily routines. For example, your doctor may recommend a diet and exercise program for weight loss to reduce the pressure on your feet. You may be advised against standing or walking for prolonged periods. Medication Surgery may be an option in more serious cases and is usually the last resort. The orthopedic surgeon may create an arch in your feet, repair tendons, or fuse your bones or joints If your Achilles tendon is too short, the surgeon can lengthen it to decrease your pain. What Is the Long-Term Outlook? It is important to understand that both pronation and supination are part of a normal, healthy walking pattern! Pronation (rolling inward) acts as a shock absorbing process and supination (rolling outward) helps to propel our feet forward. Over-pronation occurs when we pronate too deep and for too long, not giving the foot a chance to 'recover' and supinate. The foot stays flexible at all times. Over-pronators use a lot more energy when walking. Worse, over-pronation causes an imbalance throughtout the entire body, putting excessive strain on the feet, legs, knees and lower back. Many parents worry about their children's flat feet, but in most cases children grow out of it by the time they reach kindergarten. However, if you suspect your child has a severe case or does not appear to be outgrowing their flat foot, it is always best to see a podiatrist as soon as possible, preferably before age three, to evaluate and treat them if necessary. After age three flat foot treatment becomes less effective and more complicated. Structure - The standard foot has 26 bones and 2 sesamoid bones which are small, irregular bones under the base of your big toe. Perhaps the best exercise for keeping the arch healthy is the "towel scrunch." With time and decreased demand on our feet, the small muscles become weaker. Since we are no longer jumping or skipping as we did when we were kids, the muscles lose the ability to give our feet the spring they once had. To strengthen those muscles, start out barefoot in your favorite chair and spread a small hand towel on the floor in front of you. Keep reaching out and grabbing more towel until you run out. Do three sets of scrunches with a short hold at the top each day. Foot arches are springy, elastic structures that play an important role in both weight distribution and how you walk. The arches of your feet can be found by looking at the inside of your foot, where you will see a curve. When you set your foot down, this curve should not touch the ground. These curves are your arches. There are many bones, tendons, and muscles in your feet that make up foot arches. Aug 20, 2010 By Marcia Veach Photo Caption The arch will appear when people with flexible flat foot stand on their toes. Photo Credit feet image by BVDC from Fotolia.com When sitting, a person with pes plano valgus may have a reasonably well-formed arch. However, when the person stands, the arch flattens, the ankle rolls in, and the heel rolls out (everts). This complex set of position changes between sitting and standing is called pronation of the foot. A pes plano valgus foot is often maximally pronated. It should be kept in mind that the goals of non-surgical treatment of pes plano valgus are a) the elimination and/or prevention of symptoms, and b) improving activity level (functional capacity). Non-surgical measures, even custom foot orthoses (custom arch supports), should not be expected to create a permanent structural correction of the foot.