Flat Feet

Most adult feet have an arch along the inside edge of the foot. Flat foot is when this arch is apparently absent or reduced in standing.

The arches may ‘appear’ when your child is sitting, when the big toe is bent backwards or if your child stands on tiptoe.

Before the age of 3 all children have flat feet, as the arch on the inside of the foot does not begin to develop until after this age.

Even in older children flat feet do not usually cause any problems.

What causes flat feet?

The many bones in the feet are held together by stretchy bands called ligaments.
Flat feet are usually due to loose or soft ligaments and baby fat between the foot bones.

This causes the arch to fall when your child stands up which is why flat feet are sometimes called “fallen arches”.

The typical flat foot is flexible and most children have no symptoms.
Flat feet can occasionally be caused by tight muscles, which is more likely to cause pain.
There are different terms that are used to describe flat feet but essentially they all mean the same thing. They are:

• Pes planus
• Pes valgus
• Pronated feet
• Fallen arches

Will my child need treatment?

If your child does not have any associated problems with their flat feet then they are unlikely to need treating. Many people have a long -standing belief that flat feet are abnormal and require treatment with special shoes, insoles or even splints or braces.

We now know that the majority of children between 1-5 years of age have flat feet. This is part of normal development of their feet and over 95 percent of children grow out of their flat feet and develop a normal arch. The other 5 percent continue to have flat feet, but only a small number will ever have a problem. Most children with a persistent flat foot participate in physical activities, including competitive sports, and experience no pain or other symptoms. It is less important how your foot looks as to how it functions.
However, if your child complains of foot, ankle or knee pain, or has poor balance, or poor stamina in walking, then a referral to see a physiotherapist may be necessary. They can then assess the problem and treat appropriately if required.

What kind of treatment is there?

Treatment for a more severe or painful flat foot can consist of exercises and/or stretches for your child to do. It can also include your physiotherapist referring your child to an orthotist or podiatrist who specialise in providing corrective devices such as arch supports (insoles) to put in your child’s shoes. Most children with painless flexible flat feet do not need any treatment. Insoles will not change the shape of the foot and are therefore not a ‘cure’; they simply hold the foot in a better position so that it can work more effectively and may help reduce some of the symptoms.

Will anything make it worse?

No, you do not need to restrict your child’s activities. Walking barefoot, running, doing foot exercises or jumping will not make flat feet better or worse. Supportive footwear is always recommended for your child’s feet.