What It Is
Babies and toddlers appear to have flat feet when they are standing because their feet have fat pads. A slight arch may appear when the child sits or stands on tiptoes. Children are born this way; doctors refer to it as flexible flatfoot. Usually it’s painless and doesn’t interfere with a child’s ability to walk or play sports. Most children outgrow it eventually as their feet get larger, their baby fat disappears and their foot muscles strengthen with weight-bearing activity such as walking.
Signs and Symptoms
Although painless in young children, flatfeet in older children and adolescents can cause an aching pain. Sometimes the pain only occurs during or after sports or other physical activity. Sometimes the child complains that his foot, ankle, or leg is "tired"; and that he has aching pain at night. If the Achilles tendon (at the back of the ankle) is involved, it may become red and painful. Sometimes there are calluses under the sagging arches.
When to Call the Doctor
Call if your child complains of foot pain, if the ankle is red, the feet or ankles feel tired, or calluses are forming under the arches. Be sure to take your child’s shoes along to your appointment so the doctor can examine the pattern of wear. Adolescents who still have flatfeet and complain of pain should also be evaluated by a doctor.
How to Treat It
Treatment may include stretching exercises to lengthen the heel cord. Your doctor may also recommend shoe inserts called orthotics. These custom-molded arches made of composite materials provide support and relieve pain. Shoe inserts not only help people with flatfoot to walk comfortably, they also extend the life of their shoes, which otherwise would wear unevenly. In certain cases, physical therapy is recommended, and sometimes children are put in casts if the heel cords are too tight. In a few cases where other treatments don’t relieve pain, surgery is recommended.
The tendency to have flatfeet runs in families, although there can be other causes as well. It can’t be prevented.
Heel Cord Stretch
Stand 3 feet from the wall with your feet pointed straight ahead. Lower your hips to the wall without raising your heels off the floor. Hold for 5 seconds. Repeat 3 to 6 times.
Just as feet with low arches can cause problems, so can feet with high arches, sometimes called cavus foot. A high arch is sometimes seen in children but may not be noticed until adulthood. As with flatfeet, high arches sometimes are hereditary. People with high arches are vulnerable to overuse injuries during sports and exercise because their feet aren’t good shock absorbers. Not as much of the foot touches the ground to provide support for walking.
Custom-molded shoe inserts are prescribed for this condition. The inserts position the foot properly and provide shock absorption.
This material was codeveloped by the American Academy of Orthopaedic Surgeons