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 donâ€™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 childâ€™s symptoms and examine your childâ€™s feet. Your provider will watch how your child walks.
How are they treated?
If your childâ€™s feet are flexible and donâ€™t cause pain, they donâ€™t need treatment. If the feet are flat after the age of 3, they will likely stay flat but wonâ€™t be painful. Children with flexible flat feet may walk barefoot without hurting their feet. They donâ€™t need special shoes, shoe inserts, heel wedges, or any other devices.
If your childâ€™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, donâ€™t correct any misshapen bones of the feet. Thatâ€™s why itâ€™s important to have an orthopedic doctor check your child’s feet.
Stretching exercises: Stretching the muscles of the leg may be helpful. Hereâ€™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 is rarely needed for flexible flat feet. Surgery can help children who have painful flat feet or whose feet are causing serious problems with walking. 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.
Written by Robert Brayden, MD, Professor of Pediatrics, University of Colorado.
Pediatric Advisor 2015.1 published by RelayHealth. Last modified: 2014-01-28 Last reviewed: 2014-01-28
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.