Flat feet is, by a wide margin, the most common form of “foot deformity” known—perhaps 25 or 30 percent of Americans have it to some degree. When a child has flat feet, it’s known as pediatric flatfoot; most cases are also considered flexible flatfoot, meaning that the arch is present when the child sits or stands on tiptoes but flattens when bearing weight.
Why Kids’ Arches Go Flat
It takes a long time for bones to fully harden and develop. Often kids are born with very little natural arch, and whatever arch they have flattens easily when standing or walking. In most cases, this does not result in any pain or discomfort for the child, and as they grow up, the soft tissues gradually tighten and form a permanent arch by adolescence.
However, some kids never do fully develop an arch. Furthermore, in rare cases kids may have a more serious flatfoot condition (such as tarsal coalition) which is rigid—that is, the arch doesn’t appear even when not bearing weight.
Nearly all cases of flat feet in children are congenital, meaning they’re present at birth. Family history seems to play a role.
Symptoms of Pediatric Flatfoot
The good news is that most cases of pediatric flatfoot are painless, or even asymptomatic. However, some do cause difficulty, and unfortunately your child may not always be completely forthcoming with you about any symptoms they may be experiencing. That means you’ll not only have to listen to your child, but watch them carefully, too. Signs your child may be having problems include:
- Pain, cramping, or tenderness in the lower legs, including feet and knees
- Limping or awkward walking, or changes in walking gait
- Heels that appear to tilt outward
- Lower energy or early withdrawal from physical activity
- Frequent requests to be carried
- Difficulty wearing shoes
Should You Seek Treatment for Your Child?
It’s important to note that not every case of flat feet needs treatment. Some kids with flat feet experience difficulty and pain. Some grow up to be professional athletes despite never developing an arch. Every case is different, and each child needs individual attention.
For young children with flexible flat feet, the “wait and see” approach is almost always best. Definitely take them to an initial appointment—we always want to make sure that there aren’t any rarer or more serious neuromuscular conditions at work—but if there are no symptoms, treatment is usually not recommended. Instead, we’ll simply suggest you bring your child back for period re-evaluations.
Symptomatic pediatric flat foot, however, should be treated. Again, every situation is different, so we’ll perform a comprehensive exam of your child’s feet to determine which approaches will be the most effective. Conservative options may include:
- Temporary reduction in activities causing pain
- Switching to more supportive shoes
- Shoe inserts or orthotics to support your child’s foot structure
- Stretching exercises of other physical therapy
Certain, more serious types of rigid flatfoot may be best addressed with surgery, if conservative treatments prove insufficient. The chosen procedure will be carefully selected by your surgeon and will depend on a number of factors, including the severity of the problem.
At Family Foot and Ankle Center, our expert podiatrists are committed to providing the highest quality foot and ankle care to all members of your family, no matter their age or condition. If you notice your child walking with flat feet—whether there are any obvious symptoms or not—please bring them in for an initial examination. You can set up an appointment at one of our six Greater Cincinnati offices online, or by calling us at 888-689-3317.
