Dr. Jarman is a board-certified pediatric podiatrist who has been treating children with foot conditions since 2014. He knows the significance of early diagnosis and proper treatment of foot issues like flat feet, and is dedicated to your child’s health. Make an appointment with Dr. Jarman now and let him help you keep your child’s feet healthy!

Common Symptoms of Pediatric Flat Feet

Most of the time, a child with flat feet experiences no symptoms beyond the actual appearance of the foot. In this case, the condition is considered asymptomatic. Most people recognize the appearance of flat feet. Namely, the foot lies flat on the ground, with little to no arch visible. When standing behind the child, you likely can see the outer toes but not the big toe.

Children with symptomatic flat feet may display one or more of the following symptoms:

• An outward tilt at the heel
• Changes to gait or awkwardness when walking
• Difficulty moving the foot from side to side or up and down
• Feeling pain or tenderness anywhere from the foot to the knee
• Pain or difficulty when wearing shoes
• Withdrawing from physical activities

If your child experiences any of these symptoms, schedule an appointment with a pediatric podiatrist.

Diagnosing Pediatric Flat Feet

To diagnose pediatric flat feet, the podiatrist examines your child’s foot, looking for differences in its appearance when your child stands versus when he or she sits. In addition, the doctor tests the child’s range of motion and watches him or her walk. To determine the underlying cause, your podiatrist may also examine the lower leg and possibly up to the hip.

Finally, the doctor may order x-rays or other diagnostic images to determine the severity of your child’s condition.

Pediatric Flat Feet Treatment Options

If your child’s condition is symptomatic and requires treatment, there are various nonsurgical options available.

• Medication: If your child experiences pain and/or inflammation, over-the-counter medications may be prescribed to manage discomfort.
• Modify activity levels: There may need to be a temporary decrease in activities that cause your child foot pain. Your child may also need to avoid prolonged periods of standing or walking.
• Orthotics: A custom orthotic fitted inside your child’s shoe helps support structure and improve function.
• Physical therapy: Your pediatric podiatrist may supervise special stretching exercises, particularly when issues with the Achilles tendon cause the condition.
• Proper footwear: The doctor should advise you on proper footwear for a child with flat feet.

How Custom Orthotics Can Treat Flat Feet

Is surgery ever required?

In many cases of pediatric flat feet, no treatment is necessary and the child’s feet will typically develop normally over time. However, there are instances when surgical intervention may be the best course of action due to a more severe case of flat feet or an underlying cause that needs to be addressed. In these cases, several factors must be taken into consideration in order to determine the best approach for treatment, such as the degree of deformity present and the type and severity of symptoms being experienced by the patient.

The surgical options available for treating flat feet in children can range from ligament reconstruction to bone realignment procedures. These treatments are designed to restore normal alignment of the ankle joint and reduce tension on ligaments associated with flatfoot deformities. Additionally, certain procedures may involve fusing bones together or inserting a titanium stint for stability. In some cases, special orthotics or braces may also be recommended after surgery in order to further support weakened areas or correct remaining deformities.

In all instances, any decision to pursue surgical intervention should only come after careful consideration and consultation with a physician familiar with pediatric orthopedic surgery and conditions such as flatfoot in children. The goal is always to ensure that every child receives proper medical care tailored to their individual needs. To this end, it is important that any procedure chosen offers long-term benefits while minimizing potential risks associated with surgical treatment options for pediatric flat feet.

The Importance of Seeing a Pediatric Podiatrist

Since flat feet is so common, and the condition is fairly obvious, parents may choose to diagnose and treat their child. Unfortunately, this often results in the parent doing more harm than good. This is particularly true with over-the-counter shoe inserts. We cannot stress enough that you should never buy these. Not only will they NOT help your child develop an arch, improperly used shoe inserts may cause additional problems.

A pediatric podiatrist has the training and expertise needed to ensure proper diagnosis and treatment of your child’s foot issue.

Schedule an Appointment with a Pediatric Podiatrist

If your child was born with flat feet or you need treatment or advice, schedule an appointment today with one of our experienced, caring, qualified podiatrists.

Your child’s feet are designed for life

Make an appointment today if your child has Pediatric Flat Feet.

Call Dr. Jarman at 480 534-7220

Flexible Flatfoot in Children - OrthoInfo

Flexible flatfoot is a common condition in children. When a child with flexible flatfoot stands, the arch of the foot disappears. Upon sitting or when the child is on tiptoes, the arch reappears. Although called "flexible flatfoot," this condition always affects both feet.

While parents often worry that abnormally low or absent arches in a child's feet will lead to permanent deformity or disability, most children eventually outgrow flexible flatfoot without developing any problems in adulthood. The condition is usually painless and does not interfere with walking or participation in sports. If your child’s flexible flatfoot does not cause pain or discomfort, no treatment is needed.

Flexible flatfoot, showing the absence of an arch when standing. The arch reappears when the patient is sitting or on tiptoes.

A flexible flatfoot is considered to be a variation of a normal foot. The muscles and joints of a flexible flatfoot function normally.

Most children are born with very little arch in their feet. As they grow and walk, the soft tissues along the bottom of the feet tighten, which gradually shapes the arches of the feet.

Children with flexible flatfoot often do not begin to develop arches until 5 years of age or older. Some children never develop arches.

If flexible flatfoot continues into adolescence, a child may experience aching pain along the bottom of the feet. A doctor should be consulted if a child's flatfeet cause persistent pain.

To make the diagnosis, your child's doctor will examine your child to rule out other types of flatfeet that may require treatment. These include:

• Flexible flatfoot with a tight heel cord (Achilles tendon)
• Rigid flatfoot, which may be a more serious condition

Tell your child's doctor if anyone else in the family is flatfooted, as this may be an inherited condition. The doctor will also need to know about any known neurological or muscular disease in your child.

Your child's doctor will look for patterns of wear on your child's everyday shoes. They may ask your child to sit, stand, raise the toes while standing, and stand on tiptoes.

In addition, the doctor will probably examine your child's heel cords (Achilles tendons) for tightness and may check the bottoms of your child's feet for calluses.

The arch disappears when standing (left) and reappears when the child is on tiptoes (right).

Reproduced from Sullivan JA: Pedatric Flatfoot: Evaluation and Management. J Am Acad Orthop Surg 1999;7:44-53.

Treatment for flexible flatfoot is required only if your child is experiencing discomfort from the condition.

Stretching exercises. If your child has activity-related pain or tiredness in the feet, ankles, or legs, the  doctor may recommend stretching exercises for the heel cords.

Heel cord stretch.

• Heel Cord Stretch
  Lean forward against a wall with one leg in front of the other. Straighten your back leg and press your heel into the floor. Your front knee is bent. Hold for 15 to 30 seconds. Keep both heels flat on the floor. Point the toes of your back foot toward the heel of your front foot.  This stretch should be performed 3 times on each leg.

Shoe inserts (orthotics). If discomfort continues, your child's doctor may recommend shoe inserts. Soft-, firm-, and hard-molded arch supports may help relieve your child's foot pain and fatigue. They can also extend the life of your child's shoes, which may otherwise wear unevenly.

In most cases, there is little benefit to using custom-molded arch supports.  Over-the-counter arch supports, which are available at most sporting goods and running shoe stores, can be just as effective and are much less expensive to replace as your child grows. Online retailers often have inserts in difficult-to-find sizes.

Additional treatment. Your child's doctor may prescribe physical therapy or casting if your child has flexible flatfoot with tight heel cords.

A child at 3 years of age (left) with flexible flatfoot. The same child at 15 years of age (right) has a normal arch despite having received no treatment.

Reproduced from Sullivan JA: Pedatric Flatfoot: Evaluation and Management. J Am Acad Orthop Surg 1999;7:44-53.

Children almost never require surgery to treat flexible flatfoot. Occasionally, surgical treatment may be recommended for an adolescent with persistent pain, or if the flatfoot becomes rigid over time.

Surgery is typically performed to create arches in the feet by reshaping bones and lengthening tendons that may be tight and causing pain. The surgery is usually performed in stages: One foot is corrected; then, after several months of recovery, the second surgery takes place to correct the other foot.

Surgery in which an artificial implant (made of metal or silicone) is placed inside the joint between the foot and ankle to create an arch has not been well studied in children and adolescents, and should therefore be approached with caution.

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Reviewed by members of
POSNA (Pediatric Orthopaedic Society of North America)

The Pediatric Orthopaedic Society of North America (POSNA) is a group of board eligible/board certified orthopaedic surgeons who have specialized training in the care of children's musculoskeletal health. 

treatment, prevention, at what age it happens, degrees of flat feet, exercises for correction

Causes of flat feet in children

Let's start with the fact that all children are born with flat feet. This is a physiological norm (unless, of course, we are talking about a congenital anomaly), because when the baby learns to walk, the formation of the foot begins. Only by about 6-7 years can we talk about any violations - in particular, to diagnose flat feet.

Flat feet is a change in the skeleton of the foot, in which its arches are flattened. A healthy foot has two arches and three arches and rests on three points - the heel and two located on the sole in front of the fingers (metatarsals). The muscles that support the foot in a normal state are called arch supports. If these muscles do their job poorly, the arch of the foot drops and the bones move. At the same time, the foot itself lengthens and expands in the middle part, and the heel deviates outward. This is how flat feet happen. nine0005

Flat feet in children can develop for various reasons. For example, congenital deformity of the foot occurs with intrauterine malformations. Also, flat feet can develop after a foot injury or as a result of neurological pathology.

- The main causes of flat feet, according to most researchers, is a congenital condition, at the genetic level. There is post-traumatic flat feet that appears after a foot injury, and the third reason is some kind of neurological disease, for example, flat feet with clubfoot, with cerebral palsy, with paresis or paralysis. But at 90% is still genetics. You need to look at the feet of dad, mom, grandma, grandpa, there will be approximately the same picture, - explains children's orthopedist Roman Zharin . - There is also the so-called idiopathic plano-valgus foot (translated means "without reason"). In relatives of such patients, the feet are usually in perfect order, but the child himself has flat feet. And this form of flat feet in the presence of pain requires surgical treatment.

Also, some doctors note that at risk are children who are obese or rickets, who lead a sedentary lifestyle, or even wear shoes that are not properly fitted “for growth”. However, many leading experts are sure that shoes have nothing to do with it. nine0005

- As the famous orthopedist Vladimir Kenis said: “Shoes have nothing to do with the formation of the arch of the foot. This is a genetically programmed element of anatomy!” the doctor adds.

Symptoms of flat feet in children

Often, parents may not realize that their child has flat feet. In most cases, it does not interfere with the child in any way, but sometimes the baby may complain of pain and discomfort while walking.

The following symptoms may indicate a foot disorder:

• Quick fatigue - the child prefers to sit on a bench, rather than take part in active games of his peers, quickly gets tired while running or taking long walks.
• Pain in the feet (sometimes there may be pain in the knees or lower back).
• Lameness after a long walk.
• Uneven wear of shoes (the sole is only worn on the outside or inside).

Treatment of flat feet in children

In order to timely identify foot problems, you need to regularly, once a year, bring your child to an orthopedist for examination. This is especially important to do if the child complains of pain and discomfort while walking. nine0005

Diagnosis

Flat feet are detected during an appointment with an orthopedic doctor: the doctor will carefully examine the child, collect a family history - clarify whether close relatives have flat feet, if necessary, plantography is prescribed (if the child’s foot was previously covered with a dye, an imprint was made on paper , and then studied it, now the image and processing is carried out using computer technology). Officially, the diagnosis of flat feet is made only after an x-ray of the foot, which determines not only the presence, but also the type, as well as the degree of flat feet in children. nine0005

- Let's start with the fact that before the age of 7 years, the diagnosis of flat feet is generally not made. The child is constantly growing, his foot is also developing. Many children have an X-shaped deformity of the legs, which also affects the condition of the foot. Usually this x-valgus goes away somewhere by the age of 5-6, and the foot aligns. Therefore, when I hear that a child is given flat feet at the age of one, I consider this to be wrong, - Roman Zharin, an orthopedic doctor, believes.

Modern methods

– In the treatment of flat feet, the most important thing is to answer the question: does flat feet bother the child himself or is it a problem that worries only his parents. The main treatment is aimed at prevention: therapeutic massage, physiotherapy exercises, physiotherapy (electrical stimulation and paraffin boots), but you should not expect global improvements from physiotherapy, the doctor believes. nine0005

Massage is effective in the treatment of flat feet in children, as it restores blood circulation in the foot, has a positive effect on the condition of the joints and ligaments. It is better to entrust massage to a specialist, especially if the child has suffered a serious sprain or fracture. For home use, a massage mat is suitable: it affects the active points of the foot, stimulates blood circulation.

Exercise therapy for flat feet in children is considered one of the most effective methods of treatment. With regular exercises, muscles and ligaments are strengthened, the correct arch of the foot is formed. You can also do physical therapy at home: rolling a ball from toe to heel, walking on toes, heels, the inside or outside of the foot, lifting small objects with your toes. nine0005

- Some experts prescribe special orthopedic shoes for flat feet - with special insoles with arch supports, with a high back and a rigid frame. But it is worth noting that these are very heavy and uncomfortable shoes. For example, a three-year-old child in such boots will constantly stumble and fall. I do not prescribe orthopedic shoes for my patients up to 5-6 years old, and after 6 years I can prescribe orthopedic insoles to remove blockage of the foot. Real orthopedic shoes are required for children with serious pathologies - for example, after a broken foot or with cerebral palsy. Up to 5-6 years old, a child simply needs comfortable shoes - in size so that they do not dangle on their feet. As for whether an instep support is necessary, experts still differ on this matter, says Roman Zharin, an orthopedic doctor. nine0005

With regard to surgical methods for the treatment of flat feet, for example, subtalar artoeresis, in which special fixators are screwed into the foot, bringing the foot into the correct position and fixing it, preventing it from falling inward, are used relatively rarely and in severe cases, for example, with flat feet caused by cerebral palsy or other neurological diseases.

– After such an operation, the foot becomes supported, and the child can stand on his own, – explains the doctor. nine0005

Prevention of flat feet in children at home

The best prevention of flat feet in children is constant physical activity: the child should run, play, do morning exercises.

- Most of our lives we walk on a flat surface - a flat floor or asphalt, so as a prevention of flat feet, I recommend walking barefoot on an uneven surface - pebbles, earth, grass, the more often the better. But make sure that the ground is not too cold, so that the child does not step on a splinter or a sharp stone, the doctor advises. nine0005

You also need to monitor the child's weight, buy him comfortable and high-quality shoes exactly to the size of his feet.

Popular Questions and Answers

Children's orthopedist Roman Zharin answers questions.

What complications can flat feet cause in children?

The main problem of flat feet is pain and the development of arthrosis of the foot joints in the future. The gait, posture changes, the child gets tired while walking, feels pain and discomfort, especially in the morning, when it is difficult for him to disperse. However, I have seen people with absolutely flat feet more than once who work all day on their feet - and do not experience any discomfort. nine0005

Is it possible to play sports with flat feet?

With flat feet, if there is no pain, there are no restrictions in playing sports. Especially for children, various types of martial arts will be useful - karate, wushu and others, where they practice barefoot. This serves as a good prevention of flat feet.

Which footwear is best for a child?

The most important rule: shoes should be made of quality materials, comfortable, with good shock-absorbing soles, exactly in size, so as not to dangle on the foot. Some people think that shoes (especially winter ones) should be a size larger, but this is not so - there should be a small margin. nine0005

How often should a child see an orthopedist?

Every year the child should be examined by an orthopedist. After all, the baby is growing rapidly, and it is simply impossible for parents to notice many changes, this should be done by a doctor. However, I always advise parents: take pictures of the child's feet. So you took it off, put it on a hard surface and photographed it from behind. Take a new photo every 4-5 months, so you can evaluate the blockage of the foot in dynamics.

A CHILD HAS FLAT FOOT: WHAT TO DO? nine0012

Should everyone be afraid of foot pathologies?

According to statistics, about 45 percent of the adult population suffers from flat feet. However, congenital foot pathologies are observed in only 2-3 percent of people. They depend on the intrauterine position of the child and are corrected only through surgical intervention. It turns out that most defects can often be corrected during the period of foot formation (up to 12-14 years old) with quite simple and feasible actions. nine0005

From birth and by the time the baby is put on his feet, the feet of all children, without exception, seem flat because of the fat pad that protects the fragile bones of the arch of the foot from injury. The further development of children's legs depends not only on the child, but also on you.

What is flat feet, its types and causes

Accurate diagnosis of "flat feet" is possible with the help of an orthopedist at about 5-6 years old. If your child regularly complains of pain in the legs and back, gets tired when walking, if he is overweight, and his shoes and sandals are run down in one direction, this is a reason to diagnose the feet. You can do this, for example, on a special device on Health Days in Home Doctor stores, and it’s completely free. The mirror plantoscope is designed for visual express diagnostics of foot deformities. Based on the footprint, you will be able to assess the condition of the longitudinal and transverse arches, and experienced consultants will immediately give you recommendations on the selection of orthopedic products aimed at correcting or preventing the identified deformity. nine0005

The human foot is made up of 26 bones. It is less mobile than the hand, but its bones are stronger. In order for the foot to perform the functions of a support, a lifting mechanism, shock absorption upon impact, arches are present in its structure. The arches are longitudinal and transverse. The longitudinal arch, running from the metatarsal bones to the calcaneal tuber, is more pronounced. The transverse, located in the forefoot, is formed by the heads of the metatarsal bones. The deformation of the foot, which entails a decrease in the arches, is called flat feet. nine0005

Experts distinguish several types of acquired flat feet, depending on its origin. Rachitic flat feet, traumatic and static. Let's talk about the common causes of children's flat feet. These are:

• diseases (rickets, poliomyelitis) or injuries suffered in early childhood,

• endocrine disorders,

• hereditary predisposition,

50028

• excess weight,

• lack of calcium and D3, as well as some other trace elements in the child's body,

• too long stay in shoes,

• incorrectly selected shoes.

Static flat feet, which is mainly discussed in our article, happens, depending on which arch of the foot is more deformed, longitudinal, transverse and mixed (combined). Longitudinal flat feet are well defined by the imprint from the plantoscope, which we talked about earlier. Girls are more prone to transverse, and in women it can transform into Hallux valgus, or a protruding "bone" on the thumb. nine0005

Flat feet are not only an unaesthetic appearance of children's feet, but also health problems in adulthood. Arthritis, arthrosis, varicose veins, various curvature of the spine, wear and tear of the musculoskeletal system - these are the possible negative consequences of parental carelessness and the lack of timely consultation with a pediatric orthopedist.

Longitudinal flat feet of the first degree in a child is almost impossible to notice for a non-specialist. After all, with him, the baby’s legs only get a little tired in the evening and swelling of the ankles appears. The second degree of flat feet is already constant pain in the legs, not only in the feet, but also above, up to the knees. The third degree is characterized by headaches and lumbar pain, frequent swelling. Playing sports and just walking cause real torment to the child, the usual children's playfulness and optimism leave him. Many parents go to the doctor only at this stage, while it would be wiser to carefully monitor the baby and not miss the deformation of even the mildest degree. nine0005

Prevention of children's flat feet:

1. Prevention and treatment of rickets and neurological diseases in babies in the first year of life.

2. active lifestyle.

Children and adolescents should spend sufficient time in the open air, engage in physical education and sports, play outdoor games.

Where possible, on uneven and uneven surfaces. Clean lawns with grass, pebbly and sandy beaches, paved with stone and paths warmed by the sun in summer cottages or children's camps. nine0005

But what to do if there is a long winter in your area, and the whole family has to spend their holidays in the city too?

4. massage mats will come to the rescue.

Bright and multi-colored, with pebbles or with coconut fiber, acupuncture or play, they will not only ensure the correct setting of the baby's legs, but also relieve him of posture problems, muscle spasms and pain, normalize metabolism , improve immunity and mood of your children. You can just stand on the mats, you can dance or do gymnastics. nine0005

5. exercise therapy.

If your child does not like doing routine exercises, you can add an element of play to the exercises or work with him to the music.

Among the preventive movements recommended by pediatricians and orthopedists:

• Walking on heels,

• Walking on socks,

• Walking on the internal and external vaults of the foot seconds, holding hands on a support (table, chair, Swedish wall),

• Raising objects from the floor with the help of the fingers,

• Skating on the floor of the foot of gymnastic sticks or massage balls,

• Walking on knees or in a semi-Show,

• 9000 9000 5-10 squats for charging, not lifting the foot off the floor.

6. manual massage.

You can learn massage techniques on your own or book your child to a professional masseur or osteopath. It is important that not only the feet are massaged, but also the calves, ankles and the lumbar area. nine0005

7. physiotherapy.

It is carried out mainly in medical or preventive institutions, but if you have a home device, you can do it too.

8. rope or wall climbing.

Most kindergartens and schools have these ammo. But, if possible, you should install a children's sports corner at home. Follow safety precautions and do not forget to lay mats or soft rugs nearby. nine0005

9. in case of serious violations - avoidance of heavy loads on the foot.

Whatever the parent's ambitions and children's desires, ballet, running, professional football or hockey should be excluded if such is the doctor's prescription.

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