What Do I Do About My Child's Flat Feet?

As you can imagine, as a pediatrician, people ask me all sorts of things about their children’s health and development. Since the inception of Fields Footwear, people have been asking me more and more about their children’s feet. I thought it made sense to create a newsletter about common concerns regarding children’s foot health, spurred by actual questions I’ve received.

Lately my cousin has been worried because her 19 month old daughter has flat feet. She asked me about them and I reassured her that they were normal, but in order to allay her fears, I suggested she have them evaluated further. She went to both an orthopedist and a physiatrist (an MD specialized in physical medicine and rehabilitation) who recommended no further intervention. So, on that note,

“What do I do about my child’s flat feet?”

Flat feet, or pes planus, are normal in babies and toddlers because the arches in their feet haven’t yet developed. Young babies also have a fat pad on the inner border of their feet that hides the arch. Flat foot usually naturally corrects itself as muscles strengthen and soft tissues stiffen. The height of the arch in the foot increases with age until about nine years. However, 1 or 2 out of every 10 children will never develop arches in their feet. For children who do not develop an arch, treatment is NOT recommended unless the foot is stiff or painful.

Flat feet can be flexible or rigid, painful or painless and sometimes associated with a tightness of the calf muscles (Achilles tendon). Some children may experience intermittent foot pain, but using arch supports, wearing supportive shoes (read: no flip flops or open sandals), stretching of the Achilles tendon, and resting when needed, can ease this.

Flat feet DO require treatment if clearly associated with pain or decreased function. The pain can be in the sole of the foot, the arch, the ankle, or non-specific pain all around the foot area. Decreased function refers to a stiff foot, limited side-to-side foot motion, or limited up-and-down ankle motion. Children who have these symptoms should be examined by experts in pediatric foot conditions. That being said, children who have underlying neuromuscular disorders, such as cerebral palsy, should also seek the advice of experts.

If your child is not experiencing any pain or other symptoms, no further testing is usually needed. The majority of flat feet are painless and the vast majority of children with flat feet will go on to live normal, healthy lives.