Many parents are concerned when they look at their child's foot and it seems excessively flat. They are even more disturbed if one of the parents has a history of painful flat feet in their family.

Unfortunately many pediatricians tell everyone that they will "grow out" of flat feet. This is a terrible misjustice to the millions of children who have symptomatic, structural flat feet that they will not "grow out of" and often leads to many years of pain and disability when treatment can signifiacntly decrease their suffering.

Flat foot is common in children and actually stands for several types of inherited foot types. Although these deformities differ in many of their characteristics, they all share a common flattening or collapsing of the arch. Many children with flat foot have no symptoms, but some can have serious aches and pains.

Symptoms of pediatric flat foot include:


  • Pain and tenderness in the foot, leg and knees
  • Outward tilting of the heel
  • Difficulty running and walking or just "funny looking" running
  • Excessive shoe wear and difficulty fitting shoes
  • Constant complaining when running or participating in sports

What are the different kinds of flat foot?


  • Symptomatic or asymptomatic
  • Flexible (meaning they look like they have an arch when non-weightbearing but it fully collapses on weight bearing); this is the most common and associated with many overuse injuries in child athletes.
  • Rigid (arch is always stiff and flat); less common and usually due to abnormal bone structure or bone growth during development.

How is flat foot diagnosed?

In pediatric flat foot, the podiatric foot and ankle surgeon will do a complete biomechanical exam to see how the foot, knees and hips function. X-rays are taken to evaluate the growth plates and bone growth. Often, an MRI or CT scan are needed to fully evaluate this complex deformity.

How is flat foot treated?

In asymptomatic flat foot, no treatment is needed except sturdy shoe gear. Secondary symptoms of "Charlie horses" or leg cramps, tired feet, and knee and hip pain should be discussed with parents.

In painful flat feet, treatment is required. No child should be in pain from their feet. Activity modification, shoe gear, stretching exercises, anti-inflammatories and arch supports are the mainstay of therapy. Often, significant flat feet will need custom functional orthotics and physical therapy for more aggressive symptomatic relief. Weight loss is always recommended prior to surgery due to the high incidence of painful flat feet in the obese child.

Surgery should only be an option for pediatric flat foot if the child is having severe difficulty walking or running, has undergone at least 6 months of aggressive therapy and has a significant deformity.

Contact your podiatric foot and ankle surgeon for a biomechanical exam if your child is experiencing fatigue, cramping or pain associated with flat feet.