Pediatric Flat Feet
Flat feet is one of the most common deformities affecting people of all ages. Sometimes the condition is hereditary and genetic; other times an arch may collapse later in life due to injury or wear and tear. When flat feet are present at birth or a young age, the condition is known as pediatric flat foot. Whether or not it needs treatment depends on what type of flatfoot it is, and whether or not your child is experiencing any discomfort from the condition.
Flexible Pediatric Flatfoot
Nobody is born with an adult-style skeleton right off the bat. It takes time for little bones to grow and harden, and for the first few years of life they may still be very soft and flexible. This provides a lot of benefits for a growing child; it also means that they may have a case of the “disappearing arch”—there when they sit, gone when they stand due to compression from body weight.
Flexible flatfoot is by far the most common type of flat feet in children, and is rarely serious. Most kids experience no discomfort from condition and grow out of it by age 5, as developing muscles and ligaments gradually pull the arch into a more normal, rigid shape.
Rigid Pediatric Flatfoot
More rarely, a child may be born with a completely rigid flat foot, meaning that no arch appears even when the foot isn’t bearing weight, or a flexible flat foot may fail to correct itself and become a rigid flat foot over time. Although they will not necessarily experience painful symptoms, a rigid flatfoot is more likely to cause long-term trouble or be associated with other conditions, such as tarsal coalition.
Symptoms and Consequences
Pediatric flat feet, even the rigid type, will not necessarily lead to any discomfort or developmental delays for your child; after an initial evaluation, we often recommend a “wait-and-see” approach to treatment, re-evaluating periodically. In many cases no treatment may be necessary.
However, you should keep a close eye on your little one as they grow. Pain and cramping are telltale signs that something may be wrong, along with heels or feet that tilt outward or an awkward or limping gait.
Kids may not always be so forthcoming with parents when they’re having problems, so also keep an eye out for how they handle physical activities. Low energy, a tendency to avoid or quickly withdraw from physical activity, or frequent requests to be carried after short distances may indicate a problem.
If there are signs of pain or other problems, especially in the case of rigid flatfoot, it’s time to get a podiatrist involved.
Conservative approaches to reduce pain and improve function are pursued first. The first step is usually to temporarily discontinue any vigorous physical activity that lead to the painful flare-up, followed by one or more of several therapeutic or technological treatment options. This may include stretching and exercise, a change in the style or type of footwear your child wears, shoe inserts or custom orthotic devices to provide additional support or control abnormal foot motion, or other solutions.
Rarely, if the flatfoot is severe or conservative treatments are not enough, we may recommend surgical correction of the deformity. Surgery is more likely in cases of rigid flatfoot (where the condition may coincide with other bone problems that need correction). A number of different procedures are possible; the right one for your child will depend on their age and condition.
If you notice your little one’s arches sagging, especially if there’s any evidence of pain, take him or her to see Dr. Keith McSpadden at North Austin Foot & Ankle Institute. He’ll carefully evaluate your child’s condition and let you know if any treatment is recommended—and if so, what form that will take. You can request an appointment in Round Rock or Cedar Park, TX online, or by calling 512-593-2949.