Paediatric Flat Feet

There are two types of flat feet: congenital (present at birth) and acquired (can occur to all arch types at any age).

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At birth, all children should have relatively flat, soft, and chubby feet before the development and appearance of arches around the age of 2 – 3. Congenital flatfoot is a cause for concern as it can signify an underlying vertical talus or atypical joint fusion.

Paediatric cases of flat feet that is accompanied with pain should not be overlooked as they can lead to severe problems later in life. A flattening of only one foot can sometimes be a sign of underlying lower limb abnormalities such as leg length difference, angular torsion, or scoliosis.

Children’s biomechanics should be thoroughly assessed when flatfoot is suspected. Detailed consultation of the child’s status and development from birth will be made together with serial x-rays, images, or scans of the arch profile. This provides an accurate understanding of the structure, causes, and types of intervention that is needed for the child. Podiatric care for flat foot must start promptly after a diagnosis is obtained to reduce the chances of long-term foot and ankle deformities and disabilities.

How can congenital flat foot be addressed?

  • Serial casting shortly after birth to realign the placement of the foot
  • Customised foot orthotics and paediatric ankle foot orthotics with dedicated follow-up sessions to ensure the feet are developing optimally
  • In-clinic podiatric care with advanced technologies for reducing muscle tightness in the lower limbs
  • Regular focused exercises and at-home instructions to strengthen soft tissue development

Since the foot type and needs of each individual are different, using generic insoles or simply a change of footwear may be little to address underlying issues. Customised foot orthotics are specially designed to help with flat feet in children as it accurately guide the development of paediatric feet based on the child’s requirements.

When it comes to paediatric cases, timing is crucial as the bones in the feet continuously develop and ossify at different ages. Once they ossify, bone alignment becomes harder to mould or change. Prompt intervention and timely adjustments are paramount for the effective management and resolution of many lower limb alignment concerns.

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Common Symptoms

Complaints about leg and foot pain
Requests for massages to relieve aches and pains
Inability to participate in, or avoidance of, typical play and activities
Worn out footwear
Instability and falling over regularly
Alignment concerns such as an asymmetrical posture

How It Looks Like

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Related Conditions


How Do I Know If My Child Has Flat Foot?

Your child will not have an arch while standing, and the middle portion of their foot may bulge inwards and show signs of collapse. Their big toe joint may also begin to drift closer to the lesser toes, causing a larger bulge at the big toe joint. This is a noticeable sign of early juvenile bunion formation.

Can My Child’s Flat Foot Be Corrected?

If diagnosed and managed early, flat feet can be corrected. The bones and joints of your child are still malleable at 2 or 3 years old, and prompt realignment will ensure that their feet develop in a corrected position.

Should Paediatric Flat Foot Be Managed or Addressed?

This depends on the cause and if it is causing any pain. A paediatric podiatrist should be consulted promptly upon the appearance of symptoms such as complaints about leg and foot pain during activities, prolonged periods of walking, or at night, requests for massages to relieve aches and pains, inability to participate in, or avoidance of, typical play and activities, worn out footwear, instability and falling over regularly, alignment concerns such as an asymmetrical posture. Congenital flat foot due to malaligned feet can lead to other conditions such as bunions and hammertoes, or knee and back pain in the future.

Will Exercises Help Correct Flat Foot?

Exercises will not correct flat feet. While they can help strengthen muscles, they must be used in conjunction with an appropriate orthotic or custom-made device so your young child is supported during motion.

When Should Intervention Be Considered For My Child’s Flat Foot?

Problematic flat feet should be addressed as soon as it is diagnosed. The earlier flat feet is attended to, the easier the feet can be moulded and prevented from developing into a rigid deformity that requires surgery.

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Bring my daughter in year 2018 for constant pain in the feet after school PE lessons and long walking, thanks to Ms Georgina diagnosis for inflammation at both feet and was managed after 2 visits. Great advice for her flat foot with special in-soles and trek shoes. Did long term pilates too as adviced by Ms Georgina to build core muscles in supporting both feet for walking. Totally cured for now and can even go for marathon shopping! 😁

Celyn Tew

Our Podiatry Care Strategy

100% non-invasive methods

A lower limb specialist, such as a podiatrist, will be able to perform a thorough foot assessment using diagnostic tools, such as a musculoskeletal diagnostic ultrasound to determine the source of your foot pain. If surgery is required, your podiatrist will refer you to a trusted foot and ankle doctor for surgical solutions.

A thorough assessment

Immobilising the area with splints

Utilising technological therapies

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