Pediatric Flat Feet Care for Children

What Parents Should Know

Understanding pediatric flatfoot, its signs, and how it is evaluated in growing children.

Understanding Pediatric Flatfoot

Flatfoot is common in both children and adults. When this deformity occurs in children, it is referred to as pediatric flatfoot. Although there are various forms of flatfoot, they all share one characteristic: partial or total collapse of the arch. Flatfoot can be apparent at birth or it may not show up until years later.

Pediatric flatfoot can be classified as symptomatic or asymptomatic. Symptomatic flatfeet exhibit symptoms, such as pain and limitation of activity, while asymptomatic flatfeet show no symptoms. These classifications help the foot and ankle surgeon determine an appropriate treatment plan.

Most children with flatfoot have no symptoms, but some have one or more of the following: pain, tenderness, or cramping in the foot, leg, and knee; outward tilting of the heel; awkwardness or changes in walking; difficulty with shoes; reduced energy when participating in physical activities; or voluntary withdrawal from physical activities.

In diagnosing flatfoot, the foot and ankle surgeon examines the foot and observes how it looks when the child stands and sits. The surgeon observes how the child walks and evaluates range of motion of the foot. Because flatfoot is sometimes related to problems in the leg, the surgeon may also examine the knee and hip. X-rays are often taken to determine the deformity’s severity, and sometimes additional imaging and other tests are ordered. If you notice any of these signs in your child, schedule an evaluation so appropriate care can begin.

Treatment Options for Children

If a child has no symptoms, treatment is often not required. Instead, the condition will be observed and reevaluated periodically by the foot and ankle surgeon. Custom orthotic devices may be considered for some cases of asymptomatic flatfoot.

When the child has symptoms, treatment is required. The foot and ankle surgeon may select one or more nonsurgical approaches. Activity modifications ask the child to temporarily decrease activities that bring pain and avoid prolonged walking or standing. Orthotic devices fit inside the shoe to support the structure of the foot and improve function. Physical therapy, including stretching exercises supervised by the foot and ankle surgeon or a physical therapist, provides relief in some cases.

Medications such as nonsteroidal anti-inflammatory drugs (NSAIDs), like ibuprofen, may be recommended to help reduce pain and inflammation. Shoe modifications may also be advised, and the foot and ankle surgeon will guide you on footwear characteristics that are important for the child with flatfoot.

In some cases, surgery is necessary to relieve the symptoms and improve foot function. The surgical procedure or combination of procedures selected for your child will depend on his or her type of flatfoot and degree of deformity. Whenever your baby, child, or teen needs expert foot and ankle care, our goal is to guide growing feet to a happy future, whether that requires immediate treatment or long-term supervision.