What Should I Do About My Child’s Flat Feet?
What It Means To Have A “Flat Foot”
“My kid has flat feet, what should I do about it?” This is one of the most common questions I get from patients, friends and neighbors alike. “Flat foot” is a generic term that is commonly tossed around and discussed with great concern by the parents of young children. Rather than being a single condition, “flat foot,” or pes planus, constitutes a diverse group of complex foot conditions that all share a collapse of the arch of the foot.
First and foremost, it is important to understand that having a “flat foot” is often normal for infants and toddlers as the arch is not fully developed. I have this conversation with the parents of my patients on a regular basis and advise them they will most likely develop a more fully formed arch in the coming months and years.
As a child grows older however, if the arches stay flattened or fallen this is most likely the result of genetics and likely a parent or grandparent shares the condition. Knowing if a close family member also shares this condition gives important insight into whether the child may experience problems in the future which might need some form of intervention either now or later.
Another very important aspect of this to understand is that not all flat feet are symptomatic. In fact, by some estimates, up to 30 percent of adults have this condition whether they realize it or not. Flat feet are divided into symptomatic and asymptomatic groups. Many children and adults go through the day with flat feet and have no pain whatsoever. Unfortunately, some will develop painful and occasionally debilitating symptoms. The symptoms can include pain in the foot (usually arch), pain in knees or hips, leg cramping, difficulty running and keeping up with friends, rapid wearing out of shoes, and difficulty finding shoes that fit comfortably.
Flatfeet are further subdivided into flexible and rigid which is important in directing effective treatment. The type of flat foot your child has often determined what treatment is best suited for the condition. For that reason, a physical examination is necessary. A pediatric flatfoot evaluation includes a thorough biomechanical exam, gait exam and radiographs. Once the type and degree of the flat foot deformity are determined, taking into the child’s symptoms or chance of developing symptoms. a treatment plan is put into place.
Treatment of Flat Feet
Most children with this condition will benefit from conservative therapy. All children with flat feet should be wearing appropriately fitted and supportive shoes. The normal foot does something called pronation with each step to absorb shock. The flat foot is already pronated due to the fallen arch, so symptoms can develop without the proper support to counteract this over-pronation. In symptomatic children, orthotics (inserts for your shoes) can correct this biomechanical problem by controlling the motion through the heel and arch. Orthotics can take a little getting used to at first, but they are proven to alleviate painful symptoms for children with flat feet.
In cases of rigid flat feet, where the child’s gait or arch cannot be normalized with shoes and orthotics, or if the condition has not improved with conservative therapy, surgery might be needed. The goal of surgery is to help realign the joints of the foot as well as increase arch height to allow for a more normal joint range of motion and shock absorption. Surgery in children is reserved for the most severe cases of flat feet.
As a parent, you should understand that even when flat feet are noticed in small children, it does not necessarily mean that the condition needs to be treated. The best indication when treatment is needed is pain or difficulty walking or running or a strong family history of flat feet that have resulted in disability in adulthood. The best treatment for asymptomatic pediatric flatfoot is simply wearing supportive shoe gear. In most circumstances, a supportive, well-fitted running or athletic shoe should suffice.
If you have questions or concerns about your child’s flat feet, notice that they are complaining of pain, or having trouble keeping up with friends, please schedule an appointment with us at Foot and Ankle Associates of North Texas, we have offices both in Keller and Grapevine. We are also now offering telehealth visits for our established patients during the COVID-19 crisis.
