Flexible flatfoot is a common condition in children. Children with flexible flatfoot do not have a visible arch when standing or bearing weight, but the arch returns to normal when not putting weight on the foot. Most children outgrow this condition as they age and do not require medical treatment. If the condition causes pain or worsens over time, consulting with a pediatric podiatrist is advised.  Flexible flatfoot in children

Causes of Flexible Flatfoot

Flatfoot is a condition that commonly runs in families. Most infants are born with naturally flat feet because the arch has not yet developed. Flexible flatfoot is caused by the flexible ligaments in the foot that cause the arch to flatten out when standing. A traumatic injury to the foot can also cause this condition.

Preschool aged children who are most at risk for flatfoot are:

  • Those who have loose ligaments
  • Those who prefer to sit in a W-position with their knees bent and legs turned out from their body
  • Males
  • Those who are obese
  • Those who have a family member with flatfoot

Signs of Flexible Flatfoot in Children

The most obvious sign of flexible flatfoot is the lack of a visible arch in the foot. What makes flexible flatfoot different from rigid flatfoot is that the arch with flexible flatfoot reappears when the child is sitting or standing on their tiptoes. With rigid flatfoot, the arch never reappears.

Typically, flexible flatfoot causes no pain and does not prevent the child from participating in sports or other activities. Most children outgrow flatfoot by the age of 10, but in some children, the condition may exist into adulthood.

Some signs that your child may have flatfoot are:

  • Arch of the foot appears flat
  • Tired or achy feet
  • Heel bone turns outward
  • Inner part of the foot bows outward
  • Shoes cause discomfort
  • Difficulty bearing weight on the foot
  • Pain in the heels of the feet
  • Pain in the lower back and hips

When to See a Podiatrist

If your child is showing signs of flexible flatfoot or is having pain in their feet, consult with a pediatric podiatrist for an evaluation. Diagnosing flat foot can be done by a physical examination and a review of your child’s medical and family history. Imaging tests such as X-rays are not commonly needed for flexible flatfoot unless your child is experiencing pain or showing signs of rigid flatfoot or other conditions. Most podiatrists recommend observing the condition until the child gets older.

Treatment is not typically required for flexible flatfoot since your child should outgrow the condition. Often with flatfoot, the Achilles tendon is tight and can cause pain when walking or engaging in activity. If your child has any pain with flexible flatfoot, the following conservative treatments may be recommended:

  • Custom orthotics. An orthotic may be used inside the child’s shoe to give support in the arches and provide relief from pain. In addition, wearing shoes that have supportive arches can minimize pain.
  • Stretching exercises. If your child’s Achilles tendon is tight and causes pain or weakness in the foot, stretching exercises can help.
  • Physical therapy. Physical therapy can be used to help stretch the heels and to eliminate pain.
  • Medication. Over-the-counter medication such as a non-steroidal anti-inflammatory drug (NSAID’s) can be used to help reduce inflammation and pain in the feet.
  • Modified activities. If your child is experiencing pain while doing specific activities, they may need to avoid these activities or reduce the amount of time spent doing them.

Surgery is rarely needed for flexible flatfoot. In cases where flexible flatfoot causes persistent pain or is still present in adolescence or adulthood, surgery can be done to create an arch. Surgery can also be done to lengthen tendons in order to reduce pain caused by tightness.

Contact Us

If your child is experiencing pain or discomfort from flexible flatfoot or you have concerns about the health of your child’s feet, contact Capital Podiatry Associates for an evaluation. To schedule an appointment in our office or through telemedicine, call us, or fill out our convenient online contact form.


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