Flat feet

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What are flat feet?

Most feet have an arch on the inside of the foot however, some children have flat feet. Flat feet are also known as fallen arches or pes planus. They occur when the arch on the inside of the foot does not develop and the entire sole of the foot is touching the ground. It can be common for other members of the family to have flat feet.

What is the cause?

All babies and most toddlers appear to have flat feet due to their ‘baby fat’ which disguises the developing arch. Flexible flat feet are considered normal at these developmental ages. The arch on the inside of the foot may begin to develop at age 4 and should be developed by age 10.

Flat feet are just as common in populations of people who wear shoes and those who don’t wear shoes. Nearly all children with flat feet have flexible flat feet. Softening of the ligaments that hold the bones together causes flexible flat feet.

What problems will occur?

Most children with flexible flat feet do not have any symptoms. Children who have rigid or stiff flat feet may have a more serious problem and may need further treatment.

In the past, the army would reject soldiers with flat feet; however it is now known that people with flat feet have the same chance of having foot problems as people with arched feet. Those with stiff flat feet however, as mentioned, can suffer with pain and difficulty walking.

What treatment will be needed?

Early preventative treatment has been found to be of little use for flexible flat feet. The use of splinting or shoe inserts (orthotics) is not recommended, as these treatments are found to have no effect on the development of the arch. Orthotics are sometimes used for older children who have pain. These children may have other conditions as well as flat feet. Where orthotics is recommended, custom- made orthotics is not usually needed; off-the-shelf orthotics will be sufficient. Shoes are worn to protect our feet; the type of shoe cannot help feet to develop properly. The right shoes for your child are shoes that fit correctly and are affordable to you.


  • Most children with flat feet will not need treatment.
  • Orthotics do not help the development of an arch in the foot any better than a child’s natural growth.
The Children's Hospital at Westmead
Sydney Children's Hospital, Randwick
Hunter New England Kids Health

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