Flatfoot or flat feet is a common condition characterized by a lack of curvature in the feet, causing their feet to touch the floor completely. All children are born with flat feet, and they begin to develop a curvature of their feet at around three years of age (1).
Usually, flat feet in children disappear around the age of six, and only one or two out of every ten children will have flat feet as they grow into adults (2). Flat feet can be of two types—rigid and flexible (3). A flexible flatfoot is normal and not a cause for concern. However, a rigid flatfoot usually may have an underlying bone or joint problem that may require treatment. Read this post on flat feet in children to know the underlying causes and what you can do about it.
Is Flatfoot A Disability?
When children are young, their arches are yet to form, and so they naturally have flat feet. But, it corrects by itself as the child grows. However, if a child is over six or seven years of age and still continues to have flat feet, it is due to a deformity or anomaly of the heel wherein the heel bone or calcaneus rotates inward, causing the arch of the feet to collapse. While flat feet may be a deformity, it is not a disability.
Causes Of Flat Feet In Children
Not every child has the same cause of flat feet. Here are a few common ones.
1. Low muscle tone
In children with low muscle tone, their ligaments are slightly more stretchy, allowing joint motion over the normal range. It results in the heel bone rotating inwards, causing the arch to collapse and give rise to flat feet (4).
2. High muscle tone
In children with high muscle tone, the Achilles tendon pulls the foot inward, causing an arch collapse and flat feet.
3. Hypermobile joints
In the case of hypermobile joints in a child’s feet where the ligaments holding the joints are too loose, the foot’s arch collapses under their body’s weight, resulting in flat feet (1).
Some children inherit the flat feet trait from their parents (4).
Research shows that overweight children tend to have flat feet (3).
Children develop normal feet as they grow older, but they can continue having flat feet in their adulthood due to a few systemic conditions. Some of these include (5):
- Rheumatoid arthritis
- Foot or ankle injuries
- General aging process
What Are The Signs And Symptoms Of Flat Feet In Children?
Though most children with flat feet usually have no signs, some common ones observed are (5):
- Pain in the heel, foot, knee, or sometimes the entire leg
- Outward tilting of the child’s heel
- Unusual or awkward gait
- Difficulty in walking with different types of shoes
- Reduced efficiency or inability to run fast as compared to children with normal feet
- Reduced energy while participating in high-intensity activities
- A tendency to withdraw or not show interest in participating in physical activities
Are There Any Risks And Complications of Flat Feet?
Flat feet may have an impact on your child’s overall posture, gait, and muscle health. The condition could set up a chain of reactions that include (1):
- Joint pains
- Muscle weakness
- The tendency of toe walking can cause posture and gait problems
- Limping while walking or running
- Affects the development of the child’s feet
At What Age Can Flat Feet Be Diagnosed?
Flat feet in children are usually diagnosed when they are around six or seven years of age. As the child grows and their bones develop, the arches form in their feet. Though there is no right age to diagnose flat feet in children, most parents usually approach their pediatrician or a podiatrist about their child’s flat feet if the condition is not corrected by the time they turn ten or 11 years old.
How Is A Flat Foot Diagnosed?
A flat foot is diagnosed by physical examination and X-rays. A foot and ankle surgeon will first examine the feet and evaluate how the child stands, sits, and walks. They even examine the child’s range of motion. X-rays may be required to detect deformities in the feet(if any).
Rigid flat feet usually require additional investigations. If the flat feet affect the child’s hips or knees, or the child shows signs of nerve or muscle problems, X-rays and other tests may be required (6).
Treatment For Flat Feet In Children
Treatment for flat feet in children can be of two types, based on the nature and severity of the condition:
1. Non-surgical methods
These are often advised when the child has no symptoms, and the condition is regularly monitored by the foot and ankle surgeon. If the child shows signs of flat feet, the surgeon evaluates the condition and may advise one or more of the following non-surgical management options (5):
- Modification of the child’s activities
- Use of orthotics
- Physical therapies
- Use of different types of shoes
Surgical treatment for flat feet in children is recommended only when the non-surgical methods of management are not helping, or the child is suffering from aches and pains caused by them (7).
Surgical procedures used to correct flat feet include:
- Repairing a torn or stretched tendon
- Fusing one or more bones in the ankle
- Cutting or re-shaping a bone to correct the foot alignment
- Lengthening or replacement of tendons
Home Care For Flat Feet In Children
Most children with flat feet do not show symptoms and, therefore, do not require treatment. However, since their feet are flexible, parents can use a few home care management methods to help their child (after consulting the pediatrician):
- Use of custom-made insoles or inserts that support the arch
- Using appropriate shoes or footwear
- The use of braces can be helpful
- Exercises recommended by the physiotherapist
Can Flat Feet Be Prevented in Children?
Since children are naturally born with flat feet, it cannot be prevented earlier in their lives. However, if a child shows flat feet even after six or seven years of age, you can provide them shoes with extra support or shoe inserts that have arch support in them.
All babies are born with flat feet and develop their feet’ curvature around their third birthday. Flat feet is a condition and not a disability in children. While most children do not show any symptoms with flat feet, some common signs can be observed. The treatment for flat feet is usually begun in the most non-conservative way using orthotics, physiotherapy and medications. However, if a child’s flat feet are not successfully managed using non-surgical methods, surgery may be advised. Diagnosing a flatfoot condition earlier on in the child’s life is useful to correct with a better prognosis.
2. Flat Feet and Fallen Arches; Healthy Children Org (2015)
3. Dr. David Scher’ The Effects of Flat Feet in Children, HSS The Playbook (2016)
4. C Turner et al.; A Guide to the Management of Paediatric PesPlanus; Australian Journal of General Practise (2020)
5. Flat Feet; Children’s Hospital of Philadelphia
6. Pediatric Flatfoot; Foot Health Facts
7. Flexible Flat Feet; Ortho Kids
8. Flat Feet Pain & Treatment; Advanced Foot & Ankle Care Centers