Childrens flat feet
Young children have flat feet. In fact development of the foot arch takes in some cases ten years to develop. I often get concerned parents who have looked at their children’s gait and foot posture and have wondered if their children’s feet are normal. In most cases they are. However there are some feet that don’t develop an arch and although this may not cause problems later in life, it can be difficult to know.
Who to treat?
There are some clues however for parents: if your child avoids running or other high intensity activities. If they prefer to be sedentary, or complain about growing pains this can be a sign that they would benefit from arch supports. The ‘growing pains’ may be difficult to discern for your children. They may say they have pain in their feet or legs, but when you ask where exactly the pain is, they can’t tell you. They may want to be carried a lot and feel tired or have achy feet. In other words your child may not be complaining of pain directly. Sometimes they can’t tell you where the pain is. And sometimes it is more specific. In one study adolescents with flat feet were twice as likely to suffer with knee and lower back pain.
Sometimes you or your partner may have foot, ankle or knee problems due to flat feet. This can be a sign that your children may grow to have the same problem. You may notice that your child’s feet turn out, or turn in when they walk. They may be unstable when they walk or you might notice that their feet ‘don’t seem quite right’ or may not be able to keep up with their peers. It’s in these cases it could be worth seeing a podiatrist for the right opinion or treatment.
Orthotics may help with your child’s foot and ankle posture. Improving this can help with your child’s overall posture. Orthotics fit into the shoe and change the way pressure is distributed through the foot. Orthotics also change the forces that work through the foot and improve gait and posture. This means that orthotics have an effect on the entire lower limb including the knee, pelvis and lower back.
There are two types: over the counter and custom devices. The ‘over the counter’ devices are ready made and will last a year or so. They can be a good alternative for certain foot types. Wearing these does depend on the severity of flat foot. Custom orthotics on the other hand are custom made to the foot. A cast of the foot is taken with plaster of paris. This cast is sent to the orthotics laboratory with a definitive prescription for that particular foot. As well as providing a better fit, the prescription is tailored for optimal functioning for that particular pair of feet.
Good Foot Wear
When wearing orthotics, good foot wear will improve your child’s foot and ankle stability. Important points to bear in mind are
- A deep and supportive heel counter: this will support the heel and provide a safe guide for heel contact when walking.
- A supportive sole, not easily bendable and ‘twistable’. The bending should occur below the big toe joint.
- A strap or lace across the mid foot to help hold the shoe onto the foot. A lace will also, being adjustable, customize the shoe to the foot.
- A wide enough toe box. Little feet need lots of space to grow into. Little toes are malleable and can easily become deformed over time in the wrong shoes.
Please come in for a Podiatry assessment for your child. We will be happy to answer any questions you may have about your child’s feet and posture.
Yagerman SE, Cross MB, Positano R, Doyle SM. Evaluation and treatment of symptomatic pes planus.Curr Opin Pediatr. 2011;23(1):60–7.
Fabry G. Clinical practice. Static, axial, and rotational deformities of the lower extremities in children. Eur J Pediatr. 2010;169(5):529–34
Yagerman SE, Cross MB, Positano R, Doyle SM. Evaluation and treatment of symptomatic pes planus.Curr Opin Pediatr. 2011;23(1):60–7
Harris EJ, Vanore JV, Thomas JL, et al. Diagnosis and treatment of pediatric flatfoot. J Foot Ankle Surg.2004;43(6):341–73