Paediatric flat feet
Paediatric flatfoot is a common presentation in children of all ages. Many parents will come in with concerns about their children with lowered arches, worried that it may have an impact on their child’s foot function or lead to pain in the future. But is this always the case? Let’s explore what paediatric flat foot is all about and what could be done
Children with flat feet do not have an arch while weight bearing. Flat feet can be flexible or rigid. This means that an arch can be seen if a child stands up on their toes, whereas a rigid foot would not do this. Younger kids (infant-toddler age) do not have an evident arch due to the fat padding in their feet masking the area of the arch. It is common for kids to have flat feet as they are still developing and still have loose joints. By the age of six, some children may show signs of arches while standing, but this is not true for all children. It is common for more than one member or adult in the family to also have flat feet and it’s likely the child will also end up with flat feet as they reach adulthood.
So what could be done about paediatric flat feet? It depends on the presentation.
Firstly it is important to understand that flat feet at a young age are normal. However, what is not normal is the presence of pain. Pain is an indication that something is not quite right and needs further investigation. It is common for flat feet to have no causes in particular, however, in some instances, flat feet may be a symptom of something else or a contributing factor to the presence of pain for a child.
Children may not always verbalise how they feel-which is highly dependent on their age and ability to communicate. It can be seen in their body language or change in activity that is, perhaps they no longer play as much as they used to, walk with an altered gait, get tired more easily or prefer not to play anymore. If this is the case, it is worth checking with your child’s doctor/podiatrist for further assessment (especially if only one foot is affected).
A common way of managing flatfeet includes the use of orthoses (also known as insoles). Insoles come in many different forms, either being a generic, over the counter device or a custom-made orthotic. Both are effective options to use and have their own advantages if additional arch and foot support is required. While an orthotic can help create the illusion of an arch, please keep in mind that wearing an orthotic will never actually give an individual an arch or help your child develop an arch (ever or quicker)-rather they can transiently realign the foot to reduce pain and improve foot function in the presence of pathology. Flexible flat feet that are not painful do not need to be treated with insoles.
Rather, it is important for children to wear good shoes that support their growing feet. Good features to look out for in a shoe include lightweight shoes, firm heel counters to stabilise their heels, adequate toe box width and depth to protect their toes and some form of fixation (either lace-ups or Velcro straps) to secure the shoe on so the toes do not need to work hard to grip the shoes on. Be sure to check out our blog post on choosing the best footwear for children!
If you have any concerns or would like to consult a podiatrist regarding this presentation, be sure to book an appointment with one of our friendly podiatrists for expert assistance.
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