“Flatfoot” in children is a very controversial and misunderstood topic. It can range from a very mild, insignificant variation of gait to a severely deforming condition. It can have several causes, and treatment can vary in each case. For these reasons, it is essential that children with flatfoot be evaluated by a podiatrist.
Flatfoot, also called “pronation”, and “pes planus”, is the flattening of the arch with weightbearing. Because this produces an imbalance in gait, the feet must externally rotate to gain balance.
A recent European study found that flatfoot accounted for 19% of all childhood visits to podiatrists. This percentage is higher than previously suspected.
Due to looseness (laxity) of foot ligaments,98% of 18-month-old toddlers have flexible flatfoot. These figures decrease to 24% of children of age 6 years, due to development of the medial arch in early childhood. However, 7% of children of this age have more severe, rigid flat feet.
The majority of flexible flatfoot cases are asymptomatic. However, some children do become symptomatic . Common symptoms can include pain along the inside of the foot, pain along the outer foot beneath the ankle, diminished walking endurance, pain along shins, knee pain, back pain, and abnormal or clumsy gait.
All cases of flatfoot should be evaluated by a podiatrist. Although many do not require any treatment, only an expert in the foot and ankle can properly evaluate this. If the case is severe enough to require treatment, early treatment is crucial to prevent progression of symptoms and compensation and degenerative changes while aging. Unfortunately, too many parents are told that the child will “grow out of it” and do not seek treatment, often leading to later problems.
Fortunately, the vast majority of cases needing treatment are treated nonsurgically, usually with some type of in-shoe insole device or orthotic.
If your child has flatfoot or any other gait disorder such as intoeing, out toeing, or toe walking, call our offices for an appointment.