Typical or Atypical Flatfoot in Children?

Photo by Kimber Hansen Photography

A common foot concern among parents is whether or not their child has flat feet and if it is an indication that the child will have problems further on down the road. Are there things that they can do as parents that can decrease the chance that their child will be unable to participate in sports and someday, maybe someday, become a collegiate or professional athlete if they want? I know I envision my kids running along side of me on various adventures someday in the future and the thought of my child growing up developing a deformity that  prevents this from happening scares me to death! (I am trying to empathize with you, but seriously I think about this).  Here is the low down on flatfoot deformity in children.



Flatfoot is common in children.

A child's structural support begins as cartilage, which is flexible and soft. This is true also in the foot. The midfoot, or the area above the arch, is one of the last areas of the foot to ossify, or convert to bone. Because of this it isn't uncommon for children to have less structure to their feet when they are young. This is often normal. A child's foot doesn't completely convert to bone until around the age of 7 yrs. That being said there are still times when concern is warranted.

There are times when it is wise to seek a professional's opinion on the matter.

• Pain. If the child is having pain that is preventing them from being a kid then they should be evaluated. .
• Difficulty walking and running. If your child is falling a lot more than others, walks with a limp, favors one leg over the other or is more apprehensive about getting up and running around than normal, the problem could be their feet.  
• Noticeable deformity. If things just don't look right when you compare the shape of your child's feet to other kids then an evaluation is advised. 

I know....these guidelines are so broad and gray. Many conservative parents want to get their child checked just in case. If you are on the fence about seeking medical attention a few more things that could put your child at risk for greater problems include obesity, family history of painful flat feet, history of trauma or sex (males are more at risk). If your child is on the low end of the scale you may consider just monitoring the situation because many times they will resolve on their own. If your child is presenting with one or all of the above symptoms a visit to a podiatrist should be considered to obtain treatment and rule out more serious problems such as Cerebral Palsy, Muscular Dystrophy, Skewfoot and Juvenile Idiopathic Arthritis.

Treatment is usually simple.

Often times simply just wearing supportive shoes or getting a kiddie-thotic(supportive insert) can reduce pain and discomfort and get them back into action. If a more serious condition is discovered then surgical intervention may be considered but this is not common.

There is no clinical proof that orthotics worn as a child prevent flatfoot in adults. 

I am not saying that wearing orthotics as a child won't prevent flatfoot, because it might, but it also might cause other deformities(probably not, but possible). There just isn't conclusive evidence currently that shows much benefit to a child unnecessarily wearing orthotics or supportive shoes. My best advice is to just let kids be kids. I personally plan on letting my kids spend the majority of their time barefoot and if they have pain then I will consider intervening. While I am not totally on the naturalist bandwagon (because there are a lot of illogical things that happen under the "Natural" banner), I do see some wisdom in allowing feet to function the way they evolved to (this statement is in no way endorsing barefoot running off the couch BTW). Also, remember the risk factors that I pointed out earlier. If your child is at increased risk then more frequent use of supportive shoe gear and possibly orthotics can be considered.

Maybe I would put my kid in these....baby climbing shoes!!!