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Your child comes to you and says their feet always hurt. One possibility is that they have flat feet. I'm Dr. Cindy Gellner and today we'll talk about flat feet and what you can do to help your child.

Flat feet are just that, flat feet. The arch goes all the way flat. They do not have a good arch on their feet when they are just standing barefoot on the ground. Flat feet are not always a problem. Before age 3, all children have flat feet. The arches in our feet don't develop until kids are older than 3.

Reasons for Flat Feet

If your child continues to have flat feet, there may be several reasons. The most common include that they just have looser ligaments, muscles or joints, but that's not necessarily a bad thing. Children with flat feet often will complain that their feet hurt and you really don't know what caused it because there hasn't been an injury.

There are two types of flat feet. One is flexible flat feet and the other have rigid flat feet. So most children with flat feet will have flexible flat feet. When they stand up, the arch falls and it's flat. When they raise their big toe, the arch presents itself. Again, don't forget this is for children who are older than age 3 because the arch isn't going to be there until they are usually around 4 or 5. Children with flexible flat feet sometimes walk with their toes pointed inward, so they look like they are a little pigeon toed, to help them with their balance. You can also look on the soles of their shoes because parts of the soles of their shoes will actually wear out quicker than others.

Flat feet usually don't cause a lot of foot pain, but it can. Children who have more foot pain, have rigid flat feet. The child that is older, the teenagers that says his feet hurt all the time. They get more rigid and inflexible as the bones grow and the ligaments tighten up. Flat feet are easily diagnosed because your provider can just take a look at your child's feet and watch how your child walks and watch to see how that arch is when your child is standing or sitting.

Modern Treatments for Flat Feet

There is only a little bit you can do to help with flat feet. If your child's flat feet are flexible and they don't cause pain, you really don't need to do anything at all. If after age 3 they still have flat feet and are not painful, then you can really just have them wear some shoe inserts if anything if they start to have any pain. But flexible flat feet, again, do not cause a lot of pain. If your child's feet are painful, if they have the rigid flat feet, you will probably need to have some extra support in the shoes. I always tell the kids to make sure they have good supportive shoes, good athletic running shoes with an arch support in there. Some children would actually need to put an insert in there, like a shoe insert, to help with their feet and make sure that you have a good arch support in there.

We don't recommend special shoes that much anymore and we don't recommend the bracing or anything like people used to do for in-toeing and flat feet in the past. They really don't help that much. Stretching exercises are really going to be helpful and your doctor can show your child how to do the stretching exercises to help with the flexibility of rigid flat feet. On rare occasions surgery would be needed for flat feet and your child would be referred to an orthopedic specialist if your pediatrician thought your child needed surgery possible to fix the flat feet. That is very uncommon and they almost always wait to do the surgery until your child is finished or has almost finished growing to make sure they have all the bones in place before the surgery.

If your child does have flat feet, don't worry. Chances are someone else in the family has flat feet also. Arch support, good supportive shoes, that's all you really need.

updated: May 19, 2021
originally published: February 9, 2015