Flat Feet

What are flat feet?

When a child has flat feet, it means that all parts of the bottom of each foot touch the ground when your child is standing.

Flat feet are not always a problem. Before age 3, all children have flat feet. The arch of the foot does not start to develop until about 3 years of age.

What is the cause?

Older children may have flat feet for a number of reasons. Problems with ligaments, muscles, joints, bones, and the nervous system are all possible causes.

Children with conditions such as Down, Marfan, or Ehlers-Danlos syndromes are more likely to have flat feet.

What are the symptoms?

After age 3 your child could have flexible flat feet or rigid flat feet.

• Flexible flat feet: Most children with flat feet have flexibility in their feet. When a child stands on a flexible flat foot, the arch falls and is flat. The arch comes back when your child raises the big toe. Children with flexible flat feet sometimes walk with their toes pointed inward to help keep their balance. This can cause the soles of the child's shoes to wear out quickly. Flexible flat feet don’t cause foot pain.
• Rigid flat feet: As a child gets older, flat feet may get more rigid or inflexible. If this happens, your child will probably have foot pain.

How are they diagnosed?

Your healthcare provider will ask about your child’s symptoms and examine your child’s feet. Your provider will watch how your child walks.

How are they treated?

If your child’s feet are flexible and don’t cause pain, they don’t need treatment. If the feet are flat after the age of 3, they will likely stay flat but won’t be painful. Children with flexible flat feet may walk barefoot without hurting their feet. They don’t need special shoes, shoe inserts, heel wedges, or any other devices.

If your child’s feet are painful, your healthcare provider will probably refer your child to an orthopedic (bone) doctor. Depending on the cause, different treatments might help.

• Special shoes or shoe inserts: Special shoes or inserts may help relieve the pain. Shoes or inserts, however, don’t correct any misshapen bones of the feet. That’s why it’s important to have an orthopedic doctor check your child's feet.
• Stretching exercises: Stretching the muscles of the leg may be helpful. Here’s how to do the exercises:
  • Sit down with the legs straight out in front. Keep the heels of the feet in place while stretching the feet and toes upward.
  • Stand 1 to 2 feet from a wall. Lean forward and touch the wall, while keeping the heels of the feet on the ground.

  Ask your healthcare provider whether stretching exercises will help your child.

• Surgery: Surgery can help children who have painful flat feet or whose feet are causing serious problems with walking. Surgery may help some but not all symptoms. Your healthcare provider may recommend waiting to have surgery until your child has finished, or almost finished, growing.

How can I take care of my child?

Ask your healthcare provider what symptoms or problems you should watch for and what to do if your child has them. Make sure you know when you should bring your child back for a checkup.