Flat feet

Introduction

The shape of your child’s foot is made up of three parts:

1. the front – the toes and the ball of the foot that touch the ground
2. the middle – the arch of the foot that lifts upwards
3. the back – the heel of the foot that touches the ground.

In some children, the middle part of the foot will be lower or touch the ground. This is called having flat feet. Flat feet are also known as fallen arches or pes planus.

Some children are born with flat feet, which happens when the arch in the middle of the foot does not develop properly. It can also happen when your child gets older if there is an injury or wear and tear to the tissue that holds the foot together.

Flat feet can run in families and can be caused by conditions that affect the joints and tissue, including:

• cerebral palsy
• Ehlers Danlos syndrome
• muscular dystrophy.

There are generally two types of flat feet.

1. flexible flat feet – where the arch of the foot only becomes flat when standing up or putting weight on the feet
2. rigid or stiff flat feet – when the arch of the foot is always flat.

Nearly all babies and toddlers will look like they have flat feet because they carry extra fat to help them grow. The foot arch will develop properly between 4-10 years old.

Most children with flexible, flat feet do not have any symptoms.

Children with rigid or stiff, flat feet can have pain and difficulty walking properly.

The main signs of flat feet in children will be a foot arch that looks smaller than usual or completely disappears when standing up.

Other symptoms can include:

• tight muscles around the foot and leg
• ankles that roll inwards
• toes pointing outwards, also known as in-toeing
• pain in the arch of the foot.

If your child develops pain when walking, see your local doctor as soon as possible.

A doctor can diagnose flat feet by checking your child’s symptoms and doing a physical examination of their feet when standing, sitting, and walking.

They may also order scans like an X-ray to check the foot bones.

Most children will not need any treatment for flat feed. Sometimes, the doctor may recommend stretches to help with muscles and medication to treat swelling and pain.

Using equipment like splints or special shoe inserts with very young children does not affect how the arch develops.

When your child is older and their foot has finished developing, they can use special inserts called orthotics to manage pain or make shoes more comfortable. Orthotics can usually be bought from the chemist.

Flat feet and shoes

As your child gets older and learns to walk, they will start wearing shoes when outside to protect their feet from injury. Shoes cannot help the arch to develop properly, and flat feet are just as common in people who wear shoes as in people who don’t.

The right type of shoes for your child are the ones that fit correctly and are affordable for your budget. Orthotics can help shoes to fit better and reduce pain in older children.

Your child’s doctor can give you advice or refer you to a foot specialist, called a podiatrist if you need help with shoes and orthotics for your child.