Do You Really Need to Worry About Pediatric Flatfoot?

Feb 16, 2018

When you’re a parent, there’s always something new to worry about, right? Is Owen going to make good friends in school this year? Are the kids playing too rough for Ava? When is Emma’s flu going to get better?

“Flat feet” is another item we see on parents’ worry lists. Take a close look at your little one’s feet as they stand (if you can get them to stay still for a second or two!). Can you see any arch at all peeking up from the floor? Or is the whole foot flat? And if so, do you really need to worry about it?

More Common Than You Think

In 2006, an Austrian study of more than 800 children aged 3 to 6 found that 44% of the kids had at least some degree of flatfoot. And that probably underestimates the real prevalence, since more than half of the kids in the youngest group (3-year-olds) showed signs of flat feet.

In other words, most young kids experience flat feet at an early age. Obviously, most of them seem to turn out fine, although that’s not always the case. We need to dig a little deeper to find an answer.

Most Cases of Flat Feet Go Away On Their Own …

Let’s take a closer look at that same study. The average prevalence was 44%, but you discover something interesting when you break it down further by age. More than half of the youngest kids in the study (the 3-year-olds) had flat feet, but the rate for the oldest kids (6-year-olds) was less than 1 in 4. What’s going on?

The answer is that kids are growing up! When children are still very little, bones are at their most flexible, and the ligaments and tendons that maintain the arch are the most underdeveloped. During this time, the arch may not appear, or only appear when your child is sitting on tiptoes. As soon as they put weight on their feet, it flattens. This is very normal, and most kids grow out of it by around age 5-7.

… But Some Persist

Although for most kids, arch height continues to increase until it reaches “normal” level at around age 9 or 10, some feet simply remain flat. Other children may spontaneously develop a flat foot later on during childhood.

There are actually different kinds of flatfoot, too. The kind we’ve been mostly talking about might be called “flexible flatfoot,” since the arch only disappears when bearing weight. But some cases of flatfoot are more rigid, perhaps caused by an abnormal fusion of bones in the hindfoot, rather than loose tendons or ligaments.

In some cases, there are no obvious symptoms. Many kids with flat feet are able to run, play sports, and pursue their goals without any restrictions. However, for the unfortunate remainder, flat feet may be painful.

Two Children Playing in the Grass

So What Is a Parent to Do?

Whenever you notice something odd about your child’s feet or the way they walk, it’s never a bad idea to bring them in for a checkup. However, the main thing you should be looking for is pain.

If your child doesn’t appear to be in any discomfort, especially if they’re still on the young side, there’s no particular reason to be concerned. If they’re out running, playing, and showing no signs that their feet are slowing them down in any way, then there really isn’t a problem.

If, however, your child is complaining about feet that hurt, or they’re shying away from active play for reasons you don’t understand, it’s time to bring them in for a visit. No amount of foot pain is normal for a child. We’d also recommend you bring them in for at least a checkup if they reach age 8 or 9 and still have flat feet.

How Are Flat Feet Treated in Children?

We have good news! The vast majority of the time, if flat feet even need to be treated at all, it can be done conservatively. 

One of the simplest methods is simply to make sure your child has appropriate footwear. Kids old enough to be walking outside need support and cushioning in their shoes, just like adults. If they play a particular sport regularly, they should have sport-specific shoes for that activity as well. Remember also that young feet can grow fast and may need to be replaced in as little as a few months, so check regularly! Check out our page on kids’ shoes for more helpful tips on shoe shopping for little ones.

Some kids may require the extra support provided by an orthotic device. Now, we already know what you’re thinking— “Can I afford orthotics for my kid every six months until their feet stop growing?” We understand that this can be a burden for many families, which is why we offer our Orthotic Outgrowth program. This is an insurance policy we offer for kids under age 13. For $99, you’re covered for three years. No matter how many times your child outgrows their orthotics during the coverage period, new pairs (beyond the original set) will only cost $99 each.

Other treatment strategies we might suggest include: temporary activity reduction (to allow pain to subside), stretching exercises, or medications. Rarely, some forms of rigid flatfoot may ultimately need surgery to correct. Every case is different, so we’ll be sure to review your child’s condition carefully and lay out all the options and recommendations clearly.

That’s the story! Hopefully, your child is motoring around and showing no signs of pain, and you can let go of all of those fears! If there are any signs of pain, be sure to bring them in and let our caring experts have a look. You can reach the Heartland Foot & Ankle team in Bloomington, IL at (309) 661-9975 today