Flatfeet in Children: When Are They A Problem?

There are high arch feet and low arch feet and manybe evaluated. In many cases, small problems that are
different foot types in between. Many individualsdeveloping in this age group can lead to more severe
have flatfeet, but do not have foot problems. All ofproblems down the road. Generalized ankle pain is the
us are born with flatfeet and some of the greatestmost common complaint in children this age with
athletes have flatfeet. But, flatfeet are a problemflatfeet. Typically, they will be able to run and play
when the arch completely collapses in combinationsports, but find that they have a deep, achy pain in
with excess inward rotation in the foot. This type ofand around their ankle when they are done. Children
flatfoot causes excess stress on the joints, ligamentsthis age have a very difficult time expressing the
and tendons in the foot and ankle. If not treatedtype of pain they are experiencing and when they
appropriately, tendon and joint problems willexperience it. Writing down when the pain happens
develop.Flatfeet are normal in infants and the arch willand where is occurs will help your doctor during the
not start to develop until between four and eightvisit.Over fourteen years of age, the growth slows in
years of age. Up until this time, all children will havegirls and over the next few years the growth plates
flatfeet. Many children under the age of 4 may havein the feet fuse. Boys will have continued growth until
excessively flatfeet and excess rotation in their feet.16 to 18 years of age. Children in this age group will
How do you tell the difference? The following listtypically complain of pain. The most common problem
may indicate that your toddler's flatfeet are ain children with flatfeet in this age group is tendonitis.
problem:1. Your child is over 15 months of age andThe pain is either at the back of the heel, or at the
has not started walking.2. Your child started walkinginside of the arch. Sometimes the foot and ankle are
around 12 months but seems to prefer crawling.3.stiff and sore in the morning, when first stepping
Your child is between the ages of 2-4 and complainsdown. Walking up and down stairs or hills, squatting
of foot pain or leg pain. In many instances, this legor walking on uneven surfaces will cause more pain in
pain is confused with growing pains.4. The wear onthese tendons.Treatment of tendonitis involves rest,
your child's shoe is uneven.5. Your child's arch isice and immobilization for a minimum of two weeks,
touching the ground and the ankles look like they arebut two months can be a common recovery time.
rolling in, bringing the knees together.For toddlers, theWhen these conditions develop as a result of
typical treatment is a kiddie orthotic. This is aflatfeet, it is necessary to be fit with orthotics to
pre-made orthotic which comes in different sizes. Itprevent the problem from occurring again. Not every
will fit into any of your child's shoes and should befoot needs a custom made orthotic. There are many
comfortable for them. This will help stabilize their footprefabricated orthotics that work well. A
while they are walking. In severe cases, or in childrenprefabricated orthotic is not the same as an insert.
ages 3 and 4, a custom made orthotic may beAn insert slips into the shoe and will provide comfort,
necessary. A custom made orthotic is a device thatcushion and a little support. In some cases, inserts
involves taking a mold of the foot, typically donepurchased at the drugstore will help alleviate some
with plaster, but sometimes done with foam. Aarch or heel pain and give relief to sore, tired feet.
device is made with specific corrections for yourBut, an insert is not an orthotic. Orthotics are devices
child's foot and looks like a plastic insert. This insertwhich fit into the shoe and aid in foot function.The
can slip into the shoe and can be switched from shoemost important difference is an orthotic controls
to shoe.Children can wear the same insert for up toabnormal motion and corrects foot function, while an
2 shoe sizes, then a new pair must be made.insert will only provide cushion and comfort.
Although the insert will not change the way the footPre-fabricated orthotics can be found at your local
develops, it will support the foot and allow for asports store and will help many individuals with
more normal walking pattern. In some cases, childrenflatfeet. They are much cheaper than custom-made
only need the orthotic during the first few years, andorthotics, but they will wear out in 1-2 years. A
after the arch develops, the orthotic is no longercustom-made orthotic is custom to each foot and
needed. In most cases, children will not "outgrow"corrections are built-in to help the foot function. They
their flatfeet.As the arch develops between 4 and 8are designed to keep stress off the ligaments and
years of age, the child's body goes throughtendons in the arch and designed to distribute the
numerous changes. The bones grow in length whilepressure evenly while walking. The cover material on
the leg and thigh bones are rotating. During thesethe custom-made orthotic may need to be changed
years it may be difficult to determine if the flatfeetevery one to two years, but the orthotic itself will
will become a problem or not. One of best indicatorslast ten years. As expected, custom-made orthotics
of a problem is pain. Children should not have pain inare much more expensive than prefabricated
their feet. They should be able to run around withorthotics or inserts.In summary, all infants have
their friends or in an organized sport without any pain.flatfeet, but more severe flatfeet in this group can
If your child is having foot, ankle or leg pain, makebecome a problem. The arch develops between four
sure they see a podiatrist.Young children betweenand eight years of age and predicting long term foot
eight and thirteen years may have flatfeet, but notproblems in this group can be difficult. Many children,
complain of any pain. This is a common occurrence inteenagers and adults have flatfeet, yet no foot
this age group, especially if the children are notproblems. Therefore, not all flatfeet need to be
competitive in any sports. Look for the following:1.treated. But, children with foot, ankle or leg pain and
The arch touches the floor and the ankles and feetflatfeet should be evaluated by a podiatrist. For
rotate in.2. The knees are very close togetherchildren with flatfeet and foot pain, custom made
(knock-knees).3. Shoes are worn out within 3orthotics are essential to treatment of the foot
months.4. Wear pattern on the shoe is toward theproblem and for prevention of problems in the
inside (big toe side).5. Your child's gait is bouncy orfuture.Christine Dobrowolski is a podiatrist and the
looks awkward.6. Your child seems slower than his orauthor of Those Aching Feet: Your Guide to
her friends or shows a lack of interest in sportingDiagnosis and Treatment of Common Foot Problems.
activities despite being athletic.If your child shows anyTo learn more about Dr.
of these signs it is necessary to visit a podiatrist to