Pediatric Orthopedic Surgeons treating Flat Feet



Flat feet (also called pes planus or fallen arches) is a deformity in which the arches of the foot collapse when the sole of the foot comes into complete or near-complete contact with the ground.

If your child needs surgery or casting, our Fracture Care Clinic opens every day and you do not need an appointment. Surgery rooms get scheduled every morning, so your child receives the care and attention they need right away.

Flat Feet

Flat feet, aka flat foot, is a condition where a person has little to no arch in one or both feet. With this condition, when a child stands, the pads of the feet press onto the floor. In general, you don’t see an arch in the foot, even though sometimes the arch appears when you lift the foot.

All babies have flat feet until arches start forming by age 6. And around two out of 10 children usually have this condition as adults. Also, some adults have arches that collapse, which are called fallen arches. And this is another term for flat foot.

Well, flat feet may not be a problem for most children. But, if flat feet cause pain or other issues, treatments will be necessary.

How Do Flat Feet Develop?

The typical human foot has 33 joints and 26 different bones. The arches distribute body weight across the feet and legs and determine how a person walks. The arch should be sturdy yet flexible to adapt to different stress levels and surfaces.

In children with flat feet, the feet may roll to the inner side while standing and walking. This condition is called overpronation in which the feet point outward. While flat feet usually develop in childhood, this problem can also develop in adulthood.

In most cases, children with flat feet have no symptoms. However, others will experience various symptoms depending on the severity of the condition. Also, some other health issues increase your risk of flat feet, including:

  • Achilles tendon injuries
  • Broken Bones
  • Cerebral Palsy
  • Diabetes
  • Down syndrome
  • High blood pressure
  • Obesity
  • Pregnancy
  • Rheumatoid arthritis

What are the types of flat feet?

Flexible: Flexible flat feet is the most common condition. Here you can see the feet arches when you are not standing. The arches in the feet disappear when weight is put on them. Flat feet that are flexible often come during childhood or teenage years. They usually affect both feet and get worse over time. The stretch, tear and swell of the arch tendons and ligaments can cause discomfort and pain.

Rigid: In this condition, a person with rigid flat feet has no arches when standing or sitting. This condition often appears during the teen years and gets worse each year. For this condition, feet may feel painful, making it difficult to move them side-to-side and flex the feet up or down.

Adult-acquired (fallen arch): In the case of an adult-acquired flat foot, aka fallen arch, the foot’s arch drops or collapses. In this condition, the foot turns outward and can be painful. The problem may appear only on one foot. The most common reason behind this is inflammation or a tear in the leg tendon that supports the arch.

Vertical Talus: Some babies have a birth defect called vertical talus, which prevents arches from forming. The talus bone in the ankle is out of place, causing the bottom of the foot to resemble the bottom of a rocking chair. The vertical talus is also known as a rocker-bottom foot.

Symptoms of Flat Feet 

The most common symptom is pain in the feet caused by strained muscles and connecting ligaments. Excess stresses on the knee and hip may cause pain in these joints. If the ankles turn inward, the aforementioned pain is more likely to happen.  Children might experience pain and sometimes swelling or stiffness. It most commonly affects the following parts of the body:

  • knee
  • hip
  • lower back
  • lower legs
  • ankle
  • arch of the foot
  • calf

Flat feet can also lead to an uneven distribution of body weight resulting in shoes wearing down more quickly than usual or unevenly, especially on one side. And this can lead to further injuries. Some children may also have difficulty walking or running evenly.

Consult a Doctor For a Proper Diagnosis

Children who have flat feet but do not experience any pain or other symptoms may not need to see a doctor. However, if children or adolescents have the following symptoms, the parents should bring the child to see us:

  • The child or adolescent has developed flat feet recently
  • One or both feet becoming flat
  • The feet are feeling heavy, stiff, and unwieldy
  • Experiencing pain in the feet, ankles, or lower limbs
  • Symptoms not improving with supportive, well-fitted shoes

We specialize in children’s health.  As such, we can help diagnose fallen arches by observing the individual standing, walking, and examining the feet. Our doctors will examine your child’s feet from the front and back. Stand on your toes to let the doctor see the shape and function of each foot. An individual should stand on the tips of their toes to let the doctor examine the shape and functionality of each foot.

For an accurate diagnosis, a doctor will also consider the person’s medical history. Our experts may also recommend an X-ray, CT scan, MRI, or electromyography.

Exercises To Manage Flat Feet Symptoms

Our doctors may recommend a physical therapist or podiatrist and may recommend exercises to manage flat feet symptoms or to prevent them from further developing. In a 2020 study, researchers found that gait and foot alignment improved only after eight weeks of foot exercises. Doctors and surgeons often recommend the following exercises for improving strength and flexibility in the feet and ankles. These can also help in relieving symptoms of flat feet.

Heel Cord Stretching

A tight Achilles tendon supports the foot to roll inward. Heel cord stretching means stretching the Achilles tendon and posterior calf muscles.

The Golf Ball Roll

It is a simple exercise that requires a chair and a golf ball. Just sit on the chair and place your feet firmly on the ground. Roll the golf ball under your foot arch for 2 minutes to stretch the plantar fascia ligament.

Advanced Flat Feet Treatments

  •  In some cases, children with flat feet may automatically align their limbs in a way that may not show symptoms. As previously mentioned, children not experiencing symptoms do not require treatment. However, if flat feet are causing discomfort or pain, parents should look for supportive, well-fitted shoes. For extra relief, wider-fitting shoes will be a better choice.
  • Children do not usually need treatment for flat feet. However, if they experience pain, using fitted insoles and orthotics will help. Choosing custom-designed arch supports relieves pressure on the arch while reducing pain.
  • For some children, bones may not develop properly in childhood. And that can result in flat feet right from birth and continue into adulthood. While these cases are rate, our doctors are experts and can perform the surgery when needed to separate and bones that are fused together.
  • Adults may also opt for foot orthotics. If you or your child has posterior tibial tendonitis, try putting a wedge my provide some relief.  Put a wedge along the inside edge of an orthotic. It will relieve some of the load on the tendon tissue.
  • However, a person should use orthotics under the guidance of a doctor. Using the wrong orthotics or improper use can further worsen symptoms.
  • As a treatment, children can also take nonsteroidal anti-inflammatory drugs for pain relief. When obesity is one of the primary causes of flat feet, a doctor may recommend a healthy diet and exercising program to maintain a healthy body mass index and reduce the stress on the arches.


Whether a child has flat feet from birth or it has started developing recently causing a child to complain, parents should bring the child to see us as soon as possible. The sooner the diagnosis and treatment, the better.


Call 214-556-0590 to make an appointment.

Comprehensive services for children from birth through adolescence at four convenient locations: Arlington, Dallas, Frisco and McKinney.