"Does my child have flat feet, and should I be worried?"
It's one of the most common questions parents ask when they notice their child's feet look flat or their ankles seem to roll inward. The good news is that flat feet are a normal part of development for many children, especially toddlers and preschoolers. In many cases, the arches develop naturally as a child grows.
However, not all flat feet are the same. If your child still has flat feet at age 5 or 6, has foot pain, trips frequently, struggles to keep up in sports, or complains of back, ankle, knee, or leg pain, it may be a sign that their flat feet need professional evaluation.
In this guide, Seattle podiatrist Dr. Rion Berg explains what causes flat feet in children, when parents should be concerned, and what treatment options are available to help children stay active, comfortable, and healthy.
What Causes Flat Feet in Children
Developmental flatfoot (or flat feet your child does not grow out of) is inherited. Very likely you or your spouse also has flat feet. You may also have the problems that come with this foot type:
- Overpronation or the tendency to roll your feet inward when you walk or run
- Heel pain, plantar fasciitis, Achilles tendonitis, and bunions - these conditions can develop as a result of overpronation.
- Hip, back, and knee pain
Because you're likely aware of the problems that come with this foot type, it's critical to get your child evaluated so these future problems can be averted or slowed down in their development.
What Is Developmental Flatfoot?
A flatfoot deformity is diagnosed when the arch on the inside border of the foot is flatter than normal. Flatfoot deformities can occur in all age groups, but appear most commonly in children. Some of these children grow up into adults who have feet with normal arches, but many of these children have pain related to their flatfoot deformity throughout their lives. Children with flatfoot deformity must be evaluated by a podiatrist to determine if they need treatment to prevent future painful foot problems or deformity in their feet.
What Are Signs and Symptoms of Flat Feet in Children?
As a parent, it's important to watch for specific signs and symptoms that may indicate your child has pediatric flatfoot. If you notice any of the following in your children, it's important to have them evaluated.
- Complains of pain in the arch, heel, or ankle with increased standing, walking, or running activities.
- Pain in the low back, hip, knee, or leg
- Sits on the sidelines while their friends are playing
- Asks to be carried after only a short walk
- Trips and falls more than usual
- Stop doing activities they once loved
Diagnosis of (Developmental) Flat Feet in Children
As mentioned above, pediatric flatfoot can be diagnosed at a very early age, but is unlikely to be properly diagnosed unless the doctor is a foot specialist, like a podiatrist, and is familiar with the intricacies of the structure and biomechanics of the foot.
After speaking with the parent and child, the podiatrist will examine the foot both while the child is not bearing weight but also while the child is standing, walking or running. Often, the family history is also taken since the foot should be examined closely if the child has a close relative who had a painful flatfoot deformity as a child or adult.
During the examination of the child, the podiatrist is looking for abnormal structure or function of the foot and lower extremity, which could lead to either problems during childhood or adulthood. X-rays may be taken of the foot if a significant pathology is noted or suspected. The more severe the flatfoot deformity and the more significant the complaints in the foot or lower extremity, the more likely the podiatrist will recommend specific treatment for the flatfoot deformity.
Treatment of Flat Feet in Children
If the child has a mild flatfoot deformity and no symptoms, no treatment is recommended except for yearly check-ups by the podiatrist. If, however, the child has a moderate to severe flatfoot deformity or has significant symptoms in the foot or lower extremity, treatment is indicated including:
- Wearing Supportive Shoes-because kids are so active, they must wear supportive shoes to prevent foot pain and other problems. If kids wear sandals, they should also have straps that secure them to their feet.
- Wearing Over-the-Counter Shoe Inserts-kids with flat feet should at leat wear over-the-counter shoe inserts for better control.
- Orthotics for Children-more significant cases of flatfoot deformity may require more exacting control of the abnormal motion of the foot. Our office uses Little Steps Orthotics for our younger patients. Little Steps are pre-fabricated foot orthotics specifically designed for children. Little Steps can improve the appearance and function of the foot and greatly reduce the symptoms in the foot and lower extremities.
- Calf Stretches- children with tight calf muscles are also prescribed, since they can worsen the flatfoot deformity with time and make the child's symptoms worse.
