<P> Lateral X-ray of a flat foot with C - sign, which is a bony bridge between the talar dome and sustentaculum tali, in combination with a prominent inferior border of the sustentaculum tali . This represents a talocalcaneal coalition, which is an abnormal connection between the talus and calcaneus, and is thought to cause the flat foot deformity in this case . </P> <P> Training of the feet, utilizing foot gymnastics and going barefoot on varying terrain, can facilitate the formation of arches during childhood, with a developed arch occurring for most by the age of four to six years . Ligament laxity is also among the factors known to be associated with flat feet . One medical study in India with a large sample size of children who had grown up wearing shoes and others going barefoot found that the longitudinal arches of the bare - footers were generally strongest and highest as a group, and that flat feet were less common in children who had grown up wearing sandals or slippers than among those who had worn closed - toe shoes . Focusing on the influence of footwear on the prevalence of pes planus, the cross-sectional study performed on children noted that wearing shoes throughout early childhood can be detrimental to the development of a normal or a high medial longitudinal arch . The vulnerability for flat foot among shoe - wearing children increases if the child has an associated ligament laxity condition . The results of the study suggest that children be encouraged to play barefooted on various surfaces of terrain and that slippers and sandals are less harmful compared to closed - toe shoes . It appeared that closed - toe shoes greatly inhibited the development of the arch of the foot more so than slippers or sandals . This conclusion may be a result of the notion that intrinsic muscle activity of the arch is required to prevent slippers and sandals from falling off the child's foot . In children with few symptoms orthotics are not recommended . </P> <P> Flat feet can also develop as an adult ("adult acquired flatfoot") due to injury, illness, unusual or prolonged stress to the foot, faulty biomechanics, or as part of the normal aging process . This is most common in women over 40 years of age . Known risk factors include obesity, hypertension and diabetes . Flat feet can also occur in pregnant women as a result of temporary changes, due to increased elastin (elasticity) during pregnancy . However, if developed by adulthood, flat feet generally remain flat permanently . </P> <P> If a youth or adult appears flatfooted while standing in a full weight bearing position, but an arch appears when the person plantarflexes, or pulls the toes back with the rest of the foot flat on the floor, this condition is called flexible flatfoot . This is not a true collapsed arch, as the medial longitudinal arch is still present and the windlass mechanism still operates; this presentation is actually due to excessive pronation of the foot (rolling inwards), although the term' flat foot' is still applicable as it is a somewhat generic term . Muscular training of the feet is helpful and will often result in increased arch height regardless of age . </P>

What are the disadvantages of having flat feet