Pes Planus (Flat Feet)
Most babies and toddlers have flat feet because the muscles and tendons that form the arches haven't developed yet. The arches of the foot usually develop around five or six years of age. As your child grows, they may continue to have flat feet, without experiencing any issues. But if your child or teen has been diagnosed with pain as a result of flat feet, our pediatric-trained orthopedic specialists are experts in caring for the feet of children and teens.
Most babies are born with flat feet and develop arches as they grow, usually around five or six years of age. Feet usually have an arch on the inside portion of the foot. A flat foot is a foot that has lost or never developed this arch. It is often associated with the lower part of the legs being angled outwards.
Parents often first notice this because their child has what they describe as "weak ankles" (which appear to turn inward because of the way the feet are planted).
Most flat feet are flexible, rarely cause problems and usually don't require treatment. Rigid flat feet can cause problems, such as pain, and should be treated.
Parents sometimes worry that flatfeet will make their kids clumsier than other kids, but doctors say that being flatfooted isn't a cause for concern and shouldn't interfere with playing sports. Sometimes, doctors will recommend inserting arch supports into shoes to reduce foot pain.
Infants and young children naturally have flat feet. The arch should develop over time. Sometimes, the arch does not develop. It is not always clear why this happens, but reasons flat feet may develop include:
- Family history
- Diseases that cause muscle or nerve damage, such as peripheral neuropathy, diabetes, cerebral palsy, spina bifida, or muscular dystrophy
- Foot injuries
- Conditions of the feet that can injure foot tissue, such as osteoarthritis
- Conditions present at birth, such as excess laxity of joint capsules and ligaments, such as Ehlers-Danlos syndrome
Your child should see a foot specialist if they're experiencing pain and/or their pediatrician recommends further testing.
The key symptom that your child's flat feet may be causing an issue, is pain. Your doctor will consider how intense the pain is, when the pain occurs, such as during certain activities such as walking, running or stretching. The types of pain your child may be experiencing are:
You will usually be asked to bring the shoes your child wears most often in order to examine the wear patterns. This can help to determine where the foot pain is occurring. During your child's evaluation appointment, the doctor will also observe how your child walks, runs, stands and tip toes. Depending on the level of pain your child is experiencing, the doctor may also order imaging tests to view the inner workings of your child's feet. These tests may include:
- 3-D imaging
- CT scan
Most cases of flat feet don't require surgery. If your child has pain as a result of flat feet, your child's doctor may recommend the following:
- Orthotic devices such as arch supports. Depending on your child's needs, these may be available over the counter, or your child may require custom fitted devices.
- Orthotic or supportive shoes with good arch support.
- Physical therapy. If your child's pain is due to an injury related to your child's form, a pediatric-trained physical therapist can help to correct the form and prevent future injuries.
- Exercises to help relieve pain.
- Low-impact activities that put less strain on the foot.
If your child's pain persists even after these treatments, surgery may be needed done to correct the alignment of the feet.