Pediatric flatfoot

What is pediatric flatfoot?

Flatfoot is a condition that can affect both adults and children. In children, it is called “pediatric flatfoot.” When a child has pediatric flatfoot, the arch of the foot shrinks or disappears when he or she stands. The arch reappears when the child sits or stands on tiptoe. This is called flexible pediatric flatfoot.

Most children who have pediatric flatfoot are born with the condition, though it may not appear for a few years. Children will usually outgrow pediatric flatfoot on their own by the age of five.

A second, more rare kind of pediatric flatfoot is called rigid flatfoot. With this condition, the arches do not reappear when the child sits or stands on tiptoe.

What are the symptoms of pediatric flatfoot?

Most children with pediatric flatfoot have no symptoms. A parent or caregiver usually notices the condition.

Symptoms children may experience include:

  • Pain, tenderness, and/or cramping in the feet or legs, especially along the bottom of the feet
  • Heels that tilt outward
  • A change in walking
  • Pain or discomfort while walking

Parents may also notice their child withdrawing from sports and other physical activities that may cause pain in their feet and legs.

If your child experiences any of these symptoms, you should consult with your pediatrician.

Children affected by rigid flatfoot may experience more severe symptoms. Those affected with tarsal coalition, an abnormal joining of two bones in the feet, may begin to experience symptoms at preadolescence.

Children with a condition called congenital vertical talus, which causes a rigid rocker bottom appearance, may begin to experience symptoms at walking age.

How is pediatric flatfoot diagnosed?

Your pediatrician can usually diagnose pediatric flatfoot. He or she may also refer you to a foot and ankle surgical specialist. The condition is usually diagnosed by viewing the foot with the naked eye. The physician will have your child sit, stand, and walk to examine how the feet look in each situation. The physician may also examine your child’s shoes to look for patterns of wear.

In more severe cases, an X-ray may be taken to determine the extent of the deformity. Your physician may also examine the child’s knees and hips to determine if the foot condition is related to any problems in the leg.

How is pediatric flatfoot treated?

In most cases, children outgrow pediatric flatfoot without treatment. Unless the child is experiencing pain, your physician may recommend a wait-and-watch approach. You will be asked to bring your child for periodic re-evaluations.

If the child is experiencing pain, the physician may recommend hard or soft shoe inserts to support the arch. He or she may also create a custom orthotic device to fit into your child’s shoe to help support the arch and relieve the pain. In older children and adolescents, stretching exercises and physical therapy may provide relief.

In rare cases, surgery may be needed to treat pediatric flatfoot. This is more common with rigid flatfoot and in children who continue to experience pain despite non-surgical approaches. Several different types of surgery can be done, depending on the child’s age, type of flatfoot, and the degree of his or her deformity.