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.

Some children have flat feet, where the middle part of their foot is lower or touches the ground. This is also known as fallen arches or pes planus. 

Babies can be born with flat feet where the arch has not developed properly. It can also develop in older children due to injury or wear and tear on the tissue that holds the foot together.

Flat feet can be passed down in families. They can also be caused by conditions that affect the joints and tissue like:

• cerebral palsy
• Ehlers Danlos syndrome
• muscular dystrophy.

There are generally two types of flat feet.

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

Babies and toddlers may look like they have flat feet because of the extra fat they have for growing. The foot arch usually develops properly between four and ten years old. 

Children with flexible flat feet usually have no symptoms, but those with rigid flat feet may experience pain and walking difficulties.

The main signs of flat feet in children are:

• a smaller than average foot arch 
• a foot arch that disappears when your child stands up
• 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
• doing a physical examination of their feet when they are standing, sitting, and walking
• ordering scans like an x-ray to check the bones of the foot.

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

Older children can use special shoe inserts called orthotics to manage any pain and improve the fit of their shoes once their feet have finished developing. Orthotics can be bought from your local chemist.