Although the exact incidence of flatfoot in children is unknown, it is a common finding. All children have only a minimal arch at birth. This condition is not painful and generally resolves without treatment; very rarely is corrective casting necessary. Most children who present to a podiatrist for evaluation of flatfoot will have a flexible flatfoot that does not require treatment.
Common signs and symptoms:
- Pain when walking or running for any length of time
- Outward position of the heel while standing
- Awkwardness when walking or running
- Pain in shoes
The examining podiatrist must rule out the difference between “flexible” and “rigid” flatfoot. A flexible flatfoot is one that collapses while the child is standing, but the arch is visible when not standing. A rigid flatfoot is present whether or not the child is standing and often indicative of a more serious condition. Many infants have a “fat” foot and are mistaken to have flatfeet.
Your podiatrist will examine the child while standing and take x-rays to determine the severity of the condition.
Most often, if the flatfoot is asymptomatic, treatment is not required. At that time it is best to wait and observe. Custom made orthotics may be helpful in mild cases to prevent further problems from developing.
Surgical management is rarely indicated for a true flexible flatfoot. In severe cases, surgery may be necessary to relieve the symptoms and to correct the foot function. There are a variety of techniques to treat the painful pediatric flatfoot, depending on the foot type and degree of deformity.