Has your child got flat feet? Our team of Brisbane Podiatrists can help with answers.
'Flexible' Flat Foot
Children are often born with the appearance of flat feet, which can be first noticed when they are toddlers and learning to walk. Children usually develop a more normal arch appearance during the first 6-7 years of life.
These 'flexible' flat feet usually do not require specific treatment, but may require periodic monitoring if more severe. Before the age of three, there is significant fatty tissue around the arch of the foot that acts to disguise the bones and joints. This can make recognising abnormal, genetic or congenital foot conditions more difficult in infants.
Mild flexible flat feet in children does not typically require any particular treatment, as the foot will usually naturally develop over several years.
But if the conditions is more severe, and your child experiences any pain in their feet, they are limping, or the condition appears to be worsening, we recommend to have a podiatrist examine them for further. Other health conditions may compound the problem and prompt more treatment, such as joint hypermobility syndrome (including Ehler's Danlos Syndrome - EDS).
As a child’s foot is made largely of cartilage it is more susceptible to the abnormal forces that are produced by flat feet. These forces can lead to permanent structural changes to the joints and bones of the feet that will continue into adulthood.
The child may require treatment to support the arch of the foot and reduce the risk of subsequent joint problems later in life. A thorough assessment is recommended if any close relatives have had painful flat feet as a child or an adult.
'Rigid' flat foot (tarsal coalitions and similar conditions)
A ‘rigid’ flat foot is often of more concern, as it may be indicative of a congenital condition affecting the development of the bones and joints of the back part of the foot known as a ‘tarsal coalition’.
A rigid flat foot, as the name implies, is much stiffer due to bone and joint changes and cannot be passively corrected. These conditions require expert assessment and care, and may require surgery. Other congenital conditions exist that can also create a more rigid flat foot, such as a congenital vertical talus.
Other genetic disorders can also cause abnormal foot development and function and contribue to more severe flat foot conditions, including Velocardiofacial syndrome (VCFS) and Down's syndrome.
What causes flat feet in children?
Flat feet may be due to the structure of the bones, muscles and/or ligaments of the foot. Children generally have more flexibility in their ligaments which means the foot will flatten more on standing than an adult foot. Inherited genetic syndromes (eg Velocardiofacial syndrome) are also a commonly associated with paediatric flat feet.
What to look out for
Children with flexible flat feet will often have an arch present when non-weight bearing or when standing on tiptoe that flattens when standing. The flexible flat foot in a child is mainly asymptomatic. If pain occurs, it may present in the feet, knees, hips, legs or lower back. In many cases the child will ‘grow out of it’ as the muscles strengthen and the bones and joints mature, but some may require treatment to prevent ongoing problems. Parents are often concerned about the appearance of their child’s feet, especially if there is a family history of flat feet. In this case, it is worthwhile discussing these concerns with a Podiatrist.
Flat feet treatment options
For children under the age of three there is generally no need for treatment, except in severe cases. After the age of three the foot will lose the fatty padding and bone structure will be more easily observed.
If the child has no symptoms and a mild flatfoot condition then usually no treatment will be recommended. Yearly foot checks may be suggested to monitor the development of the child’s feet.
More significant cases of flat foot will be treated with supportive footwear and possible arch padding. More serious cases of flat foot can require foot orthoses (special shoe inserts) to reposition the bones and joints in the arch of the foot, and surgery may be indicated in the most severe cases.
In summary, treatment options include:
- Supportive shoes, and In-shoe modifications
- Custom or prefabricated foot orthoses or insoles
- Shoe modifications
- Adjunct physical therapy e.g. stretching, strengthening of muscles
- Surgery
Schedule Your Child's Foot Check
Concerned about your child's flat feet or any associated pain? Book a comprehensive assessment with our expert Brisbane Podiatrists to ensure optimal foot development and long-term health.