Common Causes and Best Treatments for Flat Feet in Children

What Are Flat Feet

Pes Planus is the medical term for flat feet. Flat feet meaning that the arch of the foot is collapsed or pronated where most or all of the foot is touching the ground.  Flat feet in children is extremely common seen within clinics during children’s podiatry assessments. A lot of the time the child will not be experiencing pain, fatigue and their function of the foot is adequate. If these symptoms present treatment and further assessment may be required.

What Causes Flat Feet

  • Hypermobility – where muscles ligaments and tendons stretch beyond a normal range
  • Bone formation – children are born without keystone bones that help to form the arch of the foot
  • Tight calves and Achilles tendon – reduced range of motion through the ankle joint and inwards turning of the foot
  • Cerebral palsy – Abnormal contractures in the feet to appear as flat feet
  • Autism and other neurological disorders – this can range from mild to excessive and pathology of the flat can range from wider steps when walking, low muscle tone and how the feet responses to sensory environments
  • Muscular dystrophy – a term for a collection of disorders whereby a reduced protein causes muscle weakness, abnormal muscle function and coordination
  • Juvenile arthritis – whilst the cause of this is unknown it can affect many joints in the foot and thus the muscles surrounding the joints. A compensation may be that the feet roll inwards
  • Childhood obesity – generally affects boys more than girls, excessive load results in compromised function of the foot
  • Hypotonia and low muscle tone – muscle weakness is different from low muscle tone but this can be associated with the condition. This condition is commonly picked up at birth however later in life can present as very flexible flat feet.
  • Connective tissue disorders – similar causes to low muscle tone and neurological disorders, can be to the point of having dislocations

How do Flat Feet Affect my Child

In most children pes cavus or flat feet do not cause pain and do not impair function, meaning that absolutely no affect or damage will be caused.

The main bones that form the arch of the foot develop between the ages of 3-6, it is normal for children under the age of 6 to have very mobile and flat feet. Children develop an arch as they grow and their fat pad is wide to help absorb shock for improving balance in development.

In children who maintain flat feet as they grow and develop skills they may have an altered gait due to the rolling in movement of the feet, knocking knees and restricted hip mobility.

Sometimes, flat feet in children can be picked up due to clumsiness or not keeping up with their peers, due to impaired function of their lower limb.

A parent should take note of their child when they feel like their legs are tired from walking far distances or standing on their feet for a period of time. Furthermore, growing pains in the feet and legs that are severe; a child may be at risk of increased strain on their growth plates.

Are Flat Feet Permanent

Approximately 85-90% of children outgrow the condition as they are developing, or maintain a lower arch profile and have it never cause problems.

A fallen arch foot is able to be strengthened and a shoe or device can encourage an arch to form whilst walking or performing an activity. This may result is the foot posture becoming more efficient long term.

A rigid flat foot or whereby a genetic condition is present the flat foot is likely to be permanent without surgical intention.

How do you treat flat feet

The treatment of flat feet or fallen arches are often unnecessary, however depending on the cause of the flat feet and the symptoms that are presenting, will determine which treatment is the most appropriate. More often the treatments work best in conjunction with each other, depending on the child’s age.

  • Strength and stretching – this will help will improve range of motion through muscles that may be tight or restricted as well as strengthening the surrounding muscles that are exposed to excessive force and help to reduce pressure on the joints.
  • Footwear – footwear is extremely important to get right for everyone’s individual foot type. In children with flat feet they may require footwear that offers the correct support which is in-built into the shoes
  • Orthotic or brace – this will help to correct the position of the foot and create a better alignment and should be individualised to every person’s needs for function and what is trying to be achieved
  • Surgical intervention – this is in extreme cases, casting of the calves may be needed to length the calf muscles for conditions such as cerebral palsy. Surgery may be considered if the child has or is at risk of developing arthritis and permanent joint changes.

Ultimately, treatment should only be used if the flat feet are causing a decreased quality of life. If you are concerned that your child has flat feet please book an appointment with a podiatrist for appropriate management and advice. You do not require a referral to see a podiatrist, however if you have seen other health professionals it may be helpful.

Make an appointment

Make an appointment by clicking on this link: or by calling our Moorabbin clinic at 03 9553 0044, Edithvale at 03 9772 9579 and Malvern East at 03 9021 2067.

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