Flat Feet: Definition, Diagnosis, and Military Standards

Flatfoot, also known as pes planus, is a condition characterized by the absence of the normal arch in the foot, resulting in the entire sole making contact with the ground. This condition can be present at

Recently, I went for a military re-examination, and the examination item was flatfoot (because if one has flatfoot and was born in 1970 or earlier, they only need to serve two months of supplementary military service).
However, the Ministry of National Defense's Military Medical Bureau stipulates that to be classified as flatfoot, the standing X-ray lateral view of the foot arch angle must be greater than 165 degrees.
I have searched through all the books and online resources, but I cannot find any information regarding the origin of the 165-degree criterion.
Can't flatfoot be determined directly from appearance? If not, what methods do general hospitals use for further assessment? I would greatly appreciate your response, thank you very much.

Yi ge fan nao de qing nian, 20~29 year old female. Ask Date: 2000/10/22

Dr. Pan Yingda reply Rehabilitation

No need to worry, just go serve in the military, just kidding! Generally, patients do not come to the hospital asking us to diagnose flatfoot (except for conscripts).
Flatfoot is not simply a yes or no issue; everyone has some degree of flatfoot, but there are few cases of absolute flatfoot (with a foot arch angle of 180 degrees).
It's a matter of degree! It's similar to hypertension—what qualifies as high? There needs to be a definition and data.
I initially wanted to provide some related information, but it seems you are more concerned about military service than understanding flatfoot.
Perhaps you are wondering why the angle is set at 165 degrees (instead of 160 or 170 degrees), just as one might ask why hypertension is defined as above 135/85 mmHg (previously 140/90 mmHg)? It doesn't hold much significance.
Black and white, either you have it or you don't; there's nothing to worry about or fear.
There are several assessment methods for flatfoot in medicine.
Not all flatfoot cases are exempt from military service; only those defined as flatfoot (by their criteria) are exempt.
The country needs you, so go serve! Feel free to ask if you have any questions.

Reply Date: 2000/10/22

More Info

Flat feet, or pes planus, is a condition characterized by the flattening of the arch of the foot, which can lead to various symptoms and complications. Understanding flat feet involves defining the condition, diagnosing it, and recognizing how it relates to military standards.

Definition of Flat Feet
Flat feet occur when the arches of the feet collapse, causing the entire sole to come into contact with the ground. This condition can be present at birth (congenital) or develop over time due to various factors such as injury, obesity, or aging. While many individuals with flat feet experience no symptoms, others may suffer from pain in the feet, ankles, knees, or lower back due to altered biomechanics.

Diagnosis of Flat Feet
Diagnosing flat feet typically involves a combination of physical examination and imaging studies. A healthcare provider will assess the foot's structure, looking for signs of arch collapse and evaluating the alignment of the foot and ankle.
1. Visual Inspection: The doctor may observe the foot while the patient is standing and walking. A flat arch can often be seen visually, but this is not always sufficient for a definitive diagnosis.

2. Weight-Bearing X-rays: As you mentioned, the military standard requires standing X-rays to measure the foot arch angle. The angle of the arch is typically assessed using the lateral view of the foot. The angle formed between the first metatarsal and the navicular bone is measured. A common threshold for diagnosing flat feet is an angle greater than 165 degrees, indicating a significant flattening of the arch. The specific angle of 165 degrees may stem from clinical studies that correlate this measurement with functional outcomes and symptoms. However, this specific threshold may not be universally accepted, and different institutions may have varying criteria.

3. Footprint Test: A simple method to assess flat feet is the wet footprint test, where a person steps on a surface that leaves an imprint. A flatter footprint indicates a higher likelihood of flat feet.

4. Functional Assessment: In some cases, a healthcare provider may assess how the foot functions during movement, looking for signs of overpronation or other biomechanical issues.

Military Standards and Flat Feet
In the context of military service, flat feet can affect a person's eligibility for certain roles. The military often has specific criteria for determining whether an individual is fit for service. For example, in your case, individuals born in 1969 or earlier with flat feet may only need to serve a short period in supplemental military service. The military's standards are designed to ensure that recruits can perform the physical demands of military training and duties without undue risk of injury.

Conclusion
In summary, flat feet is a condition that can be diagnosed through a combination of visual inspection, weight-bearing X-rays, and functional assessments. The specific angle of 165 degrees used by the military may be based on clinical guidelines that correlate this measurement with functional impairment. If you have concerns about your diagnosis or military eligibility, it is advisable to consult with a healthcare provider who specializes in foot and ankle conditions. They can provide a comprehensive evaluation and help clarify any uncertainties regarding military standards and your specific situation.

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