Parents are constantly asking me whether their child’s flat foot should be treated or if they will “grow out of it.”
This is one of the most controversial topics in pediatric foot care, and the debate is really over how to decide when treatment is warranted for pediatric flatfoot. The controversy rages most loudly when the flat foot in question is without pain. Many pediatricians tell parents that their child will indeed “grow out of it.” If this was true, why are we treating so many symptomatic flat feet in adults at FAANT?
It is easier to get agreement that a child with a symptomatic flatfoot should receive treatment. No one thinks a child in pain should be left untreated, especially given the myriad of options we have to relieve that pain. In that subgroup, the controversy is often over what type of treatment — over-the-counter inserts or custom orthotics — the child should receive.
The greater challenge for today’s podiatrist is having the ability to discern when treatment is necessary for children with painless flatfoot. Bear in mind that a painless flat foot does not imply an asymptomatic flat foot. Children often express their symptoms without reporting any pain. They may be lazy, frequently ask to be carried, prefer sedentary activities or have trouble keeping up with their peers.
Only doctors who discuss these issues with the parents will uncover subtle manifestations of the flat, poorly supportive foot that are already contributing to changes in activity level and functional ability. The first step in identifying flat feet that require treatment is to uncover the subtle changes in activity level and performance that may well be caused or aggravated by foot misalignment and dysfunction. After one has started treatment, parents often report a significant change in children’s activity levels, which is often to the great satisfaction of the parent. The children themselves are happier, healthier and more active as well.
Healthy Steps Shoe Store has great pre-fabricated devices that can get a symptomatic flat foot under control quickly. They are inexpensive and a great first line therapy for these children. Some kids still need a custom functional orthotic, but at least we can get them on the road to recovery much quicker with these devices.
If your child has low arches or flat feet, bring them in for a biomechanical exam and our doctors can talk to you more about the long reaching problems that can be avoided by treating their flat feet.