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Paediatric Conditions We See > Foot & Ankle

Flat Feet in Children: Causes, Symptoms,
Treatment Options, and Management

Flat feet in children, also known as flatfoot, is a common condition where one or both feet lack an arch, causing the entire sole to touch the ground. While flat feet are typically painless and common in babies and toddlers as their tendons develop, some children may experience discomfort or mobility issues that require attention. Understanding flat feet in children and knowing when to seek help is crucial for effective management. At ACME Orthopaedics, we offer tailored solutions to address flat feet, ensuring your child’s healthy growth and development. Most children will outgrow the condition as they age, but certain types of flat feet can persist into adulthood and cause complications:

1. Flexible When weight is placed on the feet, the arch disappears but is visible when you are not standing. It is usually present during childhood or the teen years; however, it can affect both feet and may gradually get worse over time.

2. Rigid This type of flat feet usually indicates that there is no arch when standing or sitting. It often develops during the teenage years and can get worse with age. Furthermore, you may experience difficulty flexing the feet, and it can be painful.

3. Adult-acquired (fallen arch) The foot’s arch unexpectedly drops or collapses, causing the foot to turn outwards. This type of flat feet is usually caused by inflammation or a tear in the leg tendon that supports the arch.

4. Vertical talus This is a congenital type of flat feet whereby the talus bone in the ankle is in the wrong position, preventing the arch from forming.

The risk of developing flat feet is not definitive and could possibly be a combination of contributing factors such as:

  • Family history of flat feet
  • Poor footwear
  • Obesity
  • Injury to the foot or ankle
  • Ageing

The causes of flat feet can be caused by the following:

  • Injury
  • Wear and tear over time
  • Underlying conditions such as diabetes, Achilles tendon injury, and cerebral palsy

Flat feet is relatively common, and most children tend to outgrow their flat feet. However, it is advisable to see a doctor if:

  • Your child is over 5 years old and has not outgrown their flat feet and is experiencing painful or stiff flat feet
  • There is a collapsed arch in their feet, causing a very broad, splayed foot
  • You notice a loss of balance in your child

Other signs to note if your child is complaining or displaying other symptoms such as:

  • Calf pain
  • Frequent tripping over their feet
  • Unbalanced shoulders
  • Unusual walking gait
  • Spine misalignment

If you or your child is experiencing painful flat feet, the following treatment options may be recommended:

  • Orthotic devices to help support the arch and relieve the pain
  • Stretching exercises to relieve pain or improve the structure of the foot
  • Physical therapy
  • Medication to relieve the pain or any inflammation

Surgery is usually the last resort if the condition is severe and requires correction. The aim of the surgery is to repair the bone and tendons causing the pain. Some procedures include:

  • Minimally invasive procedures such as an arthroereisis screw to reshape the foot
  • Lengthening of the Achilles tendon
  • Reconstruction of specific tendons
  • Calcaneal osteotomy (surgical shifting of the heel bone) to help re-align the rearfoot

Although flat feet cannot be prevented, it is essential to maintain a healthy weight to help ease the pressure and pain associated with flat feet.

To better manage flat feet, some management options include:

  • Avoid high-impact sports and activities that place stress on the feet until complete recovery
  • Opting for well-padded shoes with good arch support

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