FLAT FEET

QUESTIONS AND ANSWERS

Understanding the Causes of Flat Feet in Children

Flat feet in children can arise from various causes, often influenced by genetic, developmental, and medical factors.

Genetic Influences

One significant cause of flat feet is genetics. If a child’s parents or close relatives have flat feet, there is a higher likelihood that the child may inherit this trait. Being aware of family history can be vital for early diagnosis and management.

Developmental Variations

Many children experience flat feet due to natural developmental variations. Infants and toddlers typically exhibit flat feet because of the fatty pad in their arches. Most children develop a visible arch by age six, but in some cases, the arches fail to form as expected, leading to persistent flat feet. Moreover, tight heel cords may affect the bones and joints in the feet, contributing to the development of flat arches.

Medical Conditions

Certain medical conditions can also contribute to the development of flat feet. Conditions such as cerebral palsy, muscular dystrophy, or connective tissue disorders can impact the muscles and ligaments in the feet, resulting in a collapsed arch. Additionally, obesity can place extra strain on a child’s feet, accelerating the flattening of the arches.

Awareness of these causes is crucial for early detection and intervention. Ensuring children receive appropriate care and treatment can prevent future complications, allowing them to lead active and healthy lives.

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 child’s risk of flat feet, including:

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

Why Are Routine Check-Ups Vital for Managing Flat Feet in Children?

Routine check-ups play a crucial role in managing flat feet in children, ensuring their healthy growth and development. Here’s why scheduling regular appointments with a podiatrist is essential:

• Early Detection: Regular visits enable early identification of any irregularities or changes in foot structure. This early intervention can prevent potential complications associated with flat feet, such as pain or mobility issues.
• Personalized Care: As children grow, their feet undergo various changes. A podiatrist can provide tailored guidance and make necessary adjustments in treatment plans to suit your child’s evolving needs, ensuring optimal foot health.
• Preventative Measures: Consistent monitoring allows healthcare professionals to recommend preventative strategies, such as exercises or supportive footwear, to strengthen foot muscles and improve alignment.
• Parental Peace of Mind: Frequent consultations offer reassurance to parents, providing updates on their child’s progress and any necessary modifications to care plans.

Regular check-ups are a proactive approach, offering peace of mind and fostering an environment where children can walk, run, and play without hindrance.

When it comes to maintaining healthy foot arches in children, a proactive approach can make all the difference. Here’s how you can support your child’s foot health:

Exercise Regularly

• Toe-Curling Activities: Encourage your child to sit with a towel on the floor. They can use their toes to pull the towel toward them and then push it away. This simple activity can strengthen their arch muscles.
• Heel-Raising Exercises: Ask your child to stand with their feet apart and slowly lift onto the balls of their feet, then lower their heels back to the ground. This motion helps build strength in both the calves and arches.
• Arch Lifting Practices: While seated with their feet flat, have your child attempt to lift just the arch area without moving their toes. Holding this position for a few seconds can engage and build the supporting muscles.

How Can Weight Management Help Prevent Flat Feet?

Achieving and maintaining a healthy weight plays a vital role in preventing flat feet. Here’s how:

• Reducing Stress on Feet: Carrying extra weight places additional pressure on the arches of your feet. This can lead to flattening over time. By managing your weight, you lessen the stress on your feet, promoting arch support and health.
• Promoting Joint Health: A healthy weight can alleviate unnecessary strain on joints, including those in your feet and ankles. This helps prevent overpronation, which contributes to flat feet.
• Enhancing Mobility: When you are closer to your ideal weight, physical activity becomes less taxing. Regular movement strengthens foot muscles and ligaments, offering better support and reducing the risk of arches collapsing.
• Encouraging Circulation: Proper weight management fosters better blood circulation, which is crucial for maintaining healthy tissues and potentially preventing the deterioration of foot structures.
• Facilitating Balance and Alignment: Carrying excess weight can affect your posture and alignment, causing uneven weight distribution on your feet. Maintaining a healthy weight aids in better balance and arch integrity.

Incorporating a balanced diet rich in nutrients, alongside regular physical activity, not only supports overall health but also plays a crucial role in maintaining the integrity of your feet’s arches. By focusing on these areas, you can help prevent the onset or worsening of flat feet.

Monitor Foot Health

Regular check-ups with a podiatrist can be crucial. These visits help detect any early foot issues, ensuring timely intervention to prevent further complications. Periodically observing your child’s foot development can also aid in catching potential problems early on.

By integrating these practices into your child’s routine, you can help protect their foot arches and promote long-term health.

The Role of Proper Footwear in Preventing Flat Feet

Choosing the right footwear is crucial in preventing and managing flat feet. Shoes are more than just a fashion statement; they play an essential role in maintaining foot health.

• Significance of Support: Adequate arch support and cushioning in shoes are vital. They help distribute weight evenly across the foot, reducing stress and preventing the collapse of the arch. Athletic brands like New Balance and ASICS offer a range of supportive options.
• Orthotic Solutions: Custom orthotics or insoles are valuable tools for promoting healthy foot alignment. These tailored inserts boost arch support, making them especially beneficial during periods of growth in children. Dr. Scholl’s, for instance, provides an array of products tailored for this purpose.
• Steering Clear of High Heels: Opting for footwear with a modest heel height ensures better weight distribution and stability. High heels can put excessive strain on the arch, so it’s wise to favor shoes that maintain natural alignment.

Incorporating these footwear practices can significantly reduce the risk of developing flat feet, keeping your step both stylish and healthy.

Recommended Activity Modifications for Children with Flat Feet

For children with flat feet, it’s crucial to adjust their physical activities to ensure comfort and prevent pain. Here are some recommended modifications:

• Opt for Low-Impact Exercises: Consider activities that put less stress on the feet. Swimming and cycling are fantastic options, as they provide cardiovascular benefits with minimal impact on the feet.
• Avoid High-Impact Sports: Encourage your child to steer clear of activities that involve running or jumping, which can exacerbate discomfort in flat feet.
• Incorporate Stretching and Strengthening: Gentle stretching and strengthening exercises for the feet and ankles can be beneficial. These can help improve muscle balance and foot alignment.
• Footwear Matters: Investing in shoes with proper arch support can make a significant difference. Look for brands that offer supportive insoles specifically designed for flat feet.

By following these guidelines, children with flat feet can continue to enjoy physical activity comfortably and safely.

What are the Types of Flat Feet?

Flexible: Flexible flat feet are the most common condition. Parents can see the feet arches when the child is not standing. The arches in the feet disappear when weight is put on them. Flexible flat feet often develop 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 connective 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. Flat Feet can affect the following parts of the body:

• knee pain
• hip pain
• lower back pain
• lower leg pain
• ankle pain
• Arch of the foot pain
• calf pain

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 become 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. They will stand on their toes to let the doctor see the shape and function 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 suggest exercises to manage flat feet symptoms or to prevent them from further developing. Physical therapy focuses on stretching and strengthening tight tendons and muscles, which is vital for improving foot function. In a 2020 study, researchers found that gait and foot alignment improved only after eight weeks of foot exercises. These exercises target the enhancement of flexibility and strength in the feet and ankles, crucial elements in alleviating the discomfort associated with flat feet.

Doctors and surgeons often recommend the following exercises:

• Calf stretches to relieve tension in the Achilles tendon.
• Toe curls to strengthen the arch.
• Ankle rotations to improve joint mobility.

By incorporating these exercises, patients can expect a notable improvement in their symptoms, leading to better overall foot health.

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 child’s feet firmly on the ground. Roll the golf ball under the foot arch for 2 minutes to stretch the plantar fascia ligament.

Advanced Flat Feet Treatments

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. When selecting footwear, consider the following:

• Supportive Shoes: Opt for shoes that offer excellent arch support and cushioning. This helps alleviate the symptoms associated with flat feet by providing necessary support.
• Custom Orthotics: Consider investing in custom orthotics or insoles. These are specifically designed to support the arch and improve foot alignment. Custom solutions can be particularly beneficial for children as they grow, ensuring their feet develop properly.
• Avoid Flat Shoes: Flat shoes with minimal support can exacerbate flat feet symptoms. It’s important to choose footwear that supports the natural contour of the foot.
• Steer Clear of High Heels: High heels can place additional strain on the arches and may alter foot alignment. Instead, choose lower-heeled footwear that provides better stability and support.

By thoughtfully selecting footwear with these considerations in mind, parents can help manage their child’s flat feet more effectively.

Children do not usually need treatment for flat feet. However, if they experience pain, there are several strategies you can implement to provide relief and comfort.

Immediate Pain Management Strategies:

• Use Non-Steroidal Anti-Inflammatory Drugs (NSAIDs): Administer medications like ibuprofen to help alleviate pain and reduce inflammation. Always follow the dosage instructions suitable for children.
• Apply Ice: Place ice on the affected area to reduce swelling and soothe discomfort. Ensure the ice is wrapped in a cloth to protect the skin.
• Encourage Rest: Rest is crucial for recovery and helps in reducing strain on the feet. Encourage your child to take breaks and avoid strenuous activities.

Long-Term Solutions and Considerations:

If your child has posterior tibial tendonitis, try putting a wedge along the inside edge of an orthotic. This will relieve some of the load on the tendon tissue. However, it’s important to use orthotics under the guidance of a doctor, as using the wrong orthotics or improper use can worsen symptoms.

As a treatment, children can also take non-steroidal 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 exercise program to maintain a healthy body mass index and reduce stress on the arches. By combining both immediate pain relief methods and long-term treatment options, you can effectively manage and alleviate discomfort associated with flat feet in children.

Using fitted insoles and orthotics can be beneficial. Choosing custom-designed arch supports relieves pressure on the arch while reducing pain. For some children, bones may not develop properly in childhood, which can result in flat feet from birth and continue into adulthood. While these cases are rare, our doctors are experts and can perform surgery when needed to separate bones that are fused.

When Might Surgery Be Required?

Flat foot reconstruction surgery is seldom required, with non-surgical treatments typically recommended first. Surgery would only be considered in rare or severe cases where non-invasive methods have not provided relief. It is important to explore all non-surgical options to alleviate symptoms before considering surgery.

In summary, while surgery is a possibility for those with severe structural issues or persistent pain unresponsive to other treatments, it remains an uncommon necessity.

Conclusion

Whether a child has flat feet from birth or has started developing recently, causing the child to complain, parents should bring the child to see us as soon as possible. The sooner the diagnosis and treatment, the better. Regular monitoring of a child’s foot development is crucial for maintaining healthy growth. Frequent visits to a podiatrist provide an opportunity to catch potential problems early, ensuring minor issues don’t escalate into serious concerns. By keeping an eye on your child’s feet through routine check-ups, you can address any abnormalities quickly, fostering better foot health.

Early action and consistent monitoring work hand in hand to support your child’s overall well-being, helping them stay active and comfortable as they grow.  The sooner the diagnosis and treatment, the better. Finally, our doctors at Medical City Children’s Orthopedics and Spine Specialists, with offices in Arlington, Dallas, Flower Mound,  Frisco, and McKinney, TX, understand the importance of maintaining your child’s health. In addition, our experts and specialists have the training, knowledge, and experience required to take care of flat feet that are causing pain to your child. If your child experiences any form of pain, don’t hesitate to call our office at 214-556-0590 to schedule an appointment at one of our four locations.

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Footnote:

Medline Plus: Flat Feet