Flat feet in children

A flat foot is a deformity of the foot in which the arch is flatter than normal when the foot is at rest. A normal foot has a well-defined arch when at rest; with a flat foot, this arch is flattened and the foot may rest completely flat on the ground. A flat foot can be rigid or flexible. In the case of a flexible flat foot, the foot can still be corrected effectively. With a rigid flat foot, less correction is possible.

Most children up to the age of 2 have flat feet. This is particularly noticeable in babies, as they often have chubby feet with a lot of subcutaneous fat tissue at the level of the longitudinal arch. Between the ages of two and five, flexible flat feet occur. Most flexible flat feet correct themselves spontaneously before the age of seven.

In exceptional cases, a rigid flat foot may occur. Unlike a flexible flat foot, a rigid flat foot does not correct itself when the feet are left to dangle or when standing on tiptoes. The inside of the foot does not become arched, but remains flat.

A flexible flat foot is usually caused by laxity of the ligaments. As a result, when weight is applied, the arch of the foot sags towards the ground. When the feet are hanging down or when standing on tiptoes, the arch of the foot corrects itself. A rigid flat foot is caused by an abnormal bony bridge between the tarsal bones, also known as a tarsal coalition.

• Sagging feet, flat feet, or feet turned inwards;
• Blisters on the soles of the feet;
• Pain in the feet and/or legs
• Don’t like walking, want to be carried, want to go in the pushchair;
• Walking unsteadily, strangely or with a limp;
• Tiring quickly and cramps in the lower legs;
• Falling over a lot, tripping and being clumsy;
• bow legs;
• The insides of shoes get worn out.

During growth, children’s feet are usually supple and often sag slightly when standing or walking. However, this does not necessarily have to be a problem. Only if symptoms or extreme postural abnormalities occur is it advisable to see a podiatrist. If flat feet are suspected, the podiatrist may carry out an ultrasound scan and, if necessary, arrange for X-rays.

Treatment by a podiatrist may consist of corrective podiatric insoles, muscle-strengthening exercises and/or advice on shoes and laces. If necessary, a referral for Mensendieck or Cesar exercise therapy, or paediatric physiotherapy.

The expected result is pain relief; depending on how stiff the joints are, the flat foot may or may not persist. A flat foot can only be (partially) corrected if the abnormalities are not yet structural.