Health Information » Pediatric Orthopedics

What are flat feet?

Flat feet are a condition in which the foot doesn't have a normal arch. It may affect one foot or both feet. At first, all babies' feet look flat because an arch hasn't formed yet. Arches should form by the time your child is 2 or 3 years old, but the foot may continue to develop until your child is 8 to 10. Flat feet, even in older children, usually do not cause any problems.


What causes flat feet?

Most flat feet are caused by loose joint connections between the foot bones. The ligaments holding the bones together are loose and stretch when the child puts weight on the foot. The weight causes the arch to fall, thus you may hear the term “fallen arches”. The feet may look like they have arches when your child is sitting or when he or she walks on tiptoes.

Is this a problem?

Usually not. The natural history of flat feet is good in that it does not cause an increased risk of foot, leg, or back pain as an adult. Previously, it was thought that individuals with flat feet were not good candidates to serve in the military until a study showed the opposite to be true – those with flexible flat feet had healthier feet and did better over time and with activities.

What are the treatment options?

No specific treatment is recommended for flat feet. Typically special shoes and inserts are not recommended for flat feet that are flexible and painless. There are not any specific shoe recommendations as flat feet usually fit into all types of shoes without difficulty.

If there is pain, the inserts may be helpful. Soft arch supports are recommended for growing children as the custom inserts are rigid and can be uncomfortable and not well tolerated by children. The custom inserts are also expensive and the child is growing so quickly that they may not be cost-effective. The inserts are designed to help with discomfort, not with the arch itself. The inserts will not change the appearance of the foot nor will they help the child develop an arch.


Are there activity restrictions?

There are not any activity restrictions for children with flat feet. We encourage children be active to maintain a healthy lifestyle. Overweight children may complain of foot pain related to prolonged activities and this may be unrelated to flat feet.

Should I take my child to the doctor?

If your child complains of foot or ankle pain, take him or her to the doctor. Flat feet in an older child may cause pain in the heel or arch, or may cause pain when the child is walking and running. Your doctor will look at your child's feet to make sure that the pain isn't caused by a problem in the hip or the knee. Rarely, flat feet can be caused by foot bones that are joined together. In this case, the bones can't move, and the foot hurts. Your child may need to have x-rays, but your doctor probably can tell you what the problem is just by looking at your child's feet.

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