Flat Feet in Children – When to Seek Help

Flat Feet in Children

Every week concerned parents will call our clinic worrying that their child’s feet are flat, and that this is going to cause them all manner of problems down the track.


Thankfully, most of the time the flat feet in children is completely normal and the flatness is just part of the developmental process.

In this article I will discuss:

  • why children have flat feet,
  • when is it totally fine, and when it could be a cause for concern
  • how Podiatrist’s can set your mind at ease or implement a treatment plan to get on top of the issue, if there is one.
A baby with flat feet

Development "Flatness" of Children's Feet

For a number of reasons, children’s feet are generally much flatter than the average adult’s feet.

This is for a number of reasons including:

  • High percentage of fat (adipose) tissue in the feet of newborns and toddlers. Babies have quite a high fat content, which is a normal survial mechanism, it gives them plenty of energy if they are born into a harsh environment E.g. very cold climate, lack of food resources etc.
  • Many of the bones of the feet do not calcify (become bony) until the age of seven. This means that they don’t have riid structures yet to hold their arch in place,
  •  LIgaments which hold the bones tightly together are quite soft, meaning that there is little to hold the arch in place.
Two children running down a beach towards the ocean

Most children will start to grow an arch around the age of four and should have developed an arch by the age of 6 or 7.
Even if they don’t develop an arch by this age, it doesn’t necessarily mean that there will be a problem.
I’ll discuss problematic flat feet in children in the next section.

Signs That Flat Feet in Children is a Problem

There are however some instances when an evaluation by a podiatrist is required to see if intervention is required.

Some of the most common signs are:

  • Children complaining of pain in their feet – this is alwasy something that need further investigation as children should not experience persistent pain.
    N.B. Any pain that wakes them during the night should be investigated immediately,
  • A reluctance to be active or to play with other children – sometimes children will not complain of pain, they may just withdraw from any activity that they know will result in their feet or legs feeling sore or tired. This requires investigation and can often be quite easily remedied,
  • An uneven gait pattern – if you notice that one foot or leg behaves very differently to the other side, you should seek advice from a podiatrist. E.g. if one foot is very flat and the other has a normal or high arch, or if you notice that one shoulder or hip is much higher that the other,
  • Constantly falling or hurting themselves regularly – if you notice that your child is particularly more clumsy than other children, or more so than your previous children were at that age, it can be worth getting them checked out. Usually there is a simple cause that can be worked on with specific games and exercises but occasionally there is something else going on.
The main message I want parents and grandparents and also teachers to take from this is that there is no need to panic about flat feet in children. 
More often than not there isn’t a problem, and for most problems there are simple and non-invasive treatments. If we think anything else could be going on, a podiatrist will refer you back to your doctor for specialist referral.
Want to learn more about injury prevention in ballet? Click here.

What can a Podiatrist Can Do For Flat Feet in Children?

If we decide through thorough questioning and physical eamination that there is something which needs addressing in your child, there are several options in our kitbag to get your child up and enjoying an active, healthy lifestyle.

Here are some of the treatments we’ve had great success with:

  • Stretching and strengthening programs. With little children these are designed like games, so that we can get the child onboard because they enjoy the treatment.
  • Shoe insoles (orthotics)  are very useful in reducing pain in children with flat feet. Children’s orthotics have some special features which are different to those of adults. Our orthotic lab offers both custom and semi-custom orthotics in your childrens range.  To read more about how orthotics are made click here.
    An important note here: there is no scientific evidence that has shown that orthotics will help to “correct flat feet” and make them have the average arch. So when we use orthotics in children it is not for long term correction.

Footwear advice – sometimes it can be as simple as just getting the right shoes. Unfortunately a lot of children’s shoes are the market are of very poor quality these days, even some of the dearer ones! So we can show what features particularly will be a good fit for your child’s feet.

Worn out shoes with the big toes poking out of the shoes on a child
  • Simple shoe padding – sometimes just the right type of padding needs to be added. Your Podiatrist will cut semi-compressed felt into the correct anatomical shape to give your child’s feet the necessary support.
  • Night Splints – some conditions like Forefoot Adductus can be helped by a simple night splint which is very easy to wear and doesn’t tend to disrupt sleep.
  •  Advice on activities and sports – one thing we always strive or as podiatrists is to keep kids active, we know that long term outcomes are so much better for the longer that we’re able to keep them playing sport, dancing or whatever physical activity they love. So with that in mind, we’d rather give advice on how to adapt the way they move rather than stop them moving.

If you’re at all concerned about flat feet in your child, let our very friendly and experienced podiatrists put your mind at ease, and if needed come up with a treatment plan that works. Click the button to the left, or call 3351 8878.

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