“Your child will outgrow it” is NOT always the correct answer!

FLAT FOOT IN CHILDREN

Flat foot is common in children and is usually inherited. When the child stands, there is a noticeable flattening or collapsing of the arch. Many children with flat foot do not complain of symptoms, but some can have serious aches and pains.

Symptoms of pediatric flat foot may include pain and tenderness in the foot or leg, outward tilting of the heel, difficulty running and walking, excessive shoe wear, difficulty fitting shoes, excessive tripping and falling, and constant complaining when running or participating in sports.

There are different kinds of flat foot. It may be symptomatic or asymptomatic. It may be flexible or rigid. In flexible flatfoot, it looks like there is an arch when non-weightbearing, but it fully collapses on weight bearing; this is the most common type and is associated with many overuse injuries in child athletes. In rigid flatfoot, the arch is always stiff and flat; this is less common and usually due to abnormal bone structure or bone growth during development.

How is flat foot diagnosed?
In pediatric flat foot, the podiatric foot and ankle surgeon will do a complete biomechanical exam to see how the feet, knees and hips function. X-rays are taken to evaluate the growth plates and bone growth. Sometimes, an MRI or CT scan are needed to fully evaluate this complex deformity.

How is flat foot treated?
In asymptomatic flat foot, preventative treatment includes proper shoe gear and orthoses. Secondary symptoms of “Charlie horses” (leg cramps), tired feet, and knee and hip pain should be discussed with parents. Weight loss is always recommended for overweight pediatric patieints due to the high incidence of painful flat feet in the obese child.

In painful flat feet, treatment is required. No child should be in pain due to their feet. Activity modification, changes in shoe gear, stretching exercises, anti-inflammatories and custom made orthoses are the mainstay of therapy. Often, significant flat feet will need physical therapy for more aggressive symptomatic relief.

Surgery should only be an option for pediatric flat foot if the child is having severe difficulty walking or running, has undergone at least 6 months of aggressive therapy and has a significant deformity.

Contact our office for a biomechanical exam if your child is experiencing fatigue, cramping or pain associated with flat feet or if your are concerned about your child’s flatfeet and your pediatrician said “your child will outgrow it.”