A guide for parents whose children have flat feet

Generally feet have an arch on the inside aspect of the foot which can be seen when standing up. If someone has an arch that is low or absent when standing, we refer to this condition as flat feet. One foot or both feet may be flat. The arch in a baby’s foot has a large fat pad in it for protection and therefore does not have an arch.

Flat feet may be rigid or flexible. Ask your child to stand on tip toe. If the arch appears your child has flexible flat feet.

Flexible flat feet in children is very common. The bones in the feet are held together with ligaments and these are often loose in children. This is called ligamentous laxity or hypermobility. The increased flexibility of the ligaments allows the arch of the foot to be lower when standing. It is considered part of a child’s normal development and usually decreases with age.

In older children, feet may appear flat if there is a difference in alignment between the front and the back of the foot or if the muscles in the backs of the legs are tight.

If flat feet are more rigid, this could indicate a more severe problem where the bones are fused together or badly aligned. This usually causes pain and will require further investigation and treatment.

Do flat feet need to be treated?

Many children under the age of six have flexible flat feet. Treatment is not always required and research over the last thirty years has shown that flat footed people have no more foot problems than others. Unless your child complains of pain, is unable to walk, run or play as much as they need to, they will not necessarily require treatment.

What treatment is offered?

• Stretching and strengthening exercises.
• Orthoses (shoe inserts).

Orthoses do not fix the shape of the arch in the long term. They improve the function of feet so they work better, and usually relieve any symptoms. Children requiring orthoses often need them throughout childhood to maintain good foot position and function.

Surgery is sometimes necessary if the child has rigid flat feet.

It is essential your child’s footwear is well made and supportive as this will encourage better function and development.