Flat feet in kids: does my child need treatment?

Written by: Mr Thomas Crompton
Edited by: Cameron Gibson-Watt

Flat feet affect most young children but nearly all will grow out of it by the time they reach the age of five. For a small minority, however, treatment may be needed if this doesn’t happen and they’re experiencing symptoms such as pain and stiffness or problems with walking and balancing.

In this article, Mr Thomas Crompton, a leading consultant paediatric orthopaedic surgeon, explains the causes of flat feet, how he would examine and diagnose the condition and what treatments are available should your child need any.



What are flat feet?

Flat feet, also called pes planus or fallen arches, are defined when the feet press flat on the ground and there is little or no presence of an arch.


If you look at the sole of your child’s foot, you’ll notice that there is no arch on the inner side. However, as your child grows and their feet develop further, an arch should appear and extend from the heel to the beginning of the big toe.


What causes flat fleet?

Flat feet in young children is normal. Almost every child will have flat feet until the age of five, however, approximately one in every five children (20%) will never go on to develop an arch.


Should I worry if my child doesn’t develop an arch?

If your child is part of the 20% of children that don’t ever develop an arch but they have no symptoms or problems, then it isn’t anything to worry about. The majority of these children with flat feet will never go on to develop any problems later in life either.


When should I take my child to the doctor?

It would be best to take your child to see an orthopaedic surgeon if:

  • their feet are painful, stiff or causing discomfort
  • only one foot is affected
  •  they regularly sprain their ankle


Sometimes, there is an underlying cause for the flat feet, so further investigations and treatment may be needed in these cases.


How does a doctor diagnose the cause?

When you take your child to see an orthopaedic surgeon, they will need to carry out a physical examination and may also suggest your child has a foot X-ray done, as well as one on the knee and hip to rule out any underlying issues with these joints.


What treatment is needed for flat feet?

As many children will grow out of their flat feet, often no treatment is needed. However, in the small minority of children that experience pain and other symptoms, there are a few options to choose from:


  • Physiotherapy
  • Stretches
  • Supportive shoes
  • Arch supporting insoles


Your child must be properly assessed to ensure that you use the correct insoles or supports, as the incorrect ones may actually increase foot discomfort.


When is surgery needed?

Surgery is only recommended if initial treatments such as insoles or physiotherapy have failed to improve their symptoms - this only happens in very rare cases.


For example, surgery may need to be considered if flat feet are caused by fused foot bones, medically known as tarsal coalitions. This is where some bones in the feet do not develop properly and are abnormally connected, causing problems with foot motion. Resection surgery would therefore attempt to separate this connection enough to restore normal mobility between the bones and alleviate symptoms.


If you are worried about your child’s feet and would like to take them to see a specialist, visit Mr Thomas Crompton’s Top Doctors profile and book a consultation online to see him.

By Mr Thomas Crompton
Paediatric orthopaedics

Mr Thomas Crompton is a leading consultant orthopaedic surgeon in London, Brighton and Horley who specialises in paediatric orthopaedic surgery. His areas of expertise includes treating conditions such as trauma, hip dysplasia, flat feet and neuromuscular diseases such as cerebral palsy.

Mr Crompton qualified from Barts and the London Medical School and undertook his registrar orthopaedic training at Guy’s and St Thomas’ hospital. He underwent his specialist children’s orthopaedic fellowship at Westmead Children’s hospital in Sydney and the Royal London Hospital.

Mr Crompton is a member of the Royal College of Surgeons and the British Society for Children’s Orthopaedic Surgery.

He is also a senior office in the Aeromedical Evacuation Squadron with the Royal Airforce. The squadron provides trained medical personnel for operations requiring aeromedical evacuation in times of conflict or crisis.

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