Updated: Aug 13, 2018
Most infants are born with flat feet, but after they start walking and their bones and soft tissue structures begin to develop, an arch usually forms. By the time children are 8 to 10 years of age, though, the arch has usually developed so beyond this point, there may be no further maturation of the arch. Because flatfoot deformity can lead to pain and subsequent problems in the feet, ankles, lower legs, and even up into the hips and back, it is important to identify it early, so treatment options can be implemented, if necessary.
What to Look For
1. Fallen Arches/Arch Height
This can be assessed a couple different ways. The most obvious thing is to look at the height of your child’s arches when they are standing. If they are touching the ground, or close to it, they may have flat feet. The wet test can also be performed.
2. Other Foot Changes
Flatfoot deformity is often solely equated with having fallen arches, but it is actually a complex condition that can result in changes elsewhere in the foot.
While standing behind your child, look at their heels. In flatfoot deformity, often the heels angle outwards into a valgus position (see picture below). From this same position, look at their toes. If you can see more than two toes (the 4th& 5th toes), this is considered a positive “too many toes” sign and can be seen in children with flat feet.
As the feet overpronate in flatfoot deformity, the knees also roll inward, causing them to be closer together or even touch. This may become more evident when the child is walking or running.
4. Duck Walk
This walking style results from the arches overpronating and collapsing, causing the toes to turn outwards (abduct). Parents may say that their child walks like a duck. The medical term for this gait pattern is “out-toeing.”
5. Shoe Wear Pattern
Examine an older pair of your child’s shoes. In children with flat feet, they often wear out the medial (inside) part of their outer soles. You may see wear along the inside heel region and/or along the entire inside section of the outer sole.
6. Location(s) of Pain
Because of the position of the feet in flatfoot deformity, malalignment of the entire lower extremity results, putting strain on several regions, including the bottoms of the feet or along the insides of the arch or midfoot region. They could even have pain in their ankles or lower legs (i.e. shin splints). Because of the flatness in the child’s feet, it can make them less efficient while running, so they may also complain of increased fatigue.
7. Your Child Doesn’t Want to Play
Not all children complain of pain, so it is important to pay close attention to their behavior. Do they all of a sudden want to stay inside all the time instead of playing outside? Do they need to rest during their soccer game more frequently because their legs are tired? These could be signs that their flat feet are causing problems.
Treatment of Flatfoot Deformity
During a child’s early years of life, having flat feet is actually normal. If an arch has not developed by the age of 10 years, though, the chances of further development is not likely. The treatment options for flat feet depend on the severity of the deformity and the presence, or absence, of pain. In children, this often means making sure they are wearing proper athletic shoes and adding an orthotic that can help realign their lower extremities, thus making them more biomechanically efficient. Children should also avoid barefoot walking (even in the house), flat shoes, and flip-flops. Activities do not need be limited, as long as the child is not in pain.
Because there is often a genetic component to flat feet, there may be no way to completely avoid the development of the deformity. This does not mean there are not ways to support the feet, though, and potential slow down the progression of the flatness from occurring. It often goes back to shoe gear, avoiding barefoot walking, and wearing orthotics. Furthermore, it is important to keep in mind that there are several adults who live with flat feet their entire lives and do not have pain or any associated problems. If you are concerned about your child’s flat fleet, it is important to consult a healthcare professional for further evaluation.
DISCLAIMER: The above information is meant for educational purposes only and should not be construed as medical advice. Please consult the doctor, or your own healthcare professional, should you have questions or concerns related to your health.