Flat Feet/Fallen Arches (Paediatric Pes Planus)
Pes planus is a condition where the arch of the foot either fails to develop or collapses/ flattens.
Paediatric flat feet occur when the inner surface of the foot or the entire sole of the child’s feet contacts with the floor when standing.
Flat feet are fairly common in kids, especially between the ages of 1 and 6, as children’s bones and joints are flexible. Moreover, young infants also have a fat pad on the inner border of their feet.
By the age of 7, children will acquire into their adult foot and lower limb posture.
About 15-20% of children might not outgrow the condition and will continue to have flat feet into their adulthood. Most children with flat feet rarely require treatment.
Treatment is only required if the child complains of stiff, bony and / or painful feet, or if they have hypermobility of the ligaments of the foot and ankle leading to flat feet.
Common Symptoms Of Paediatric Flat Feet
Most of the time, children with flat feet experience no symptoms at all, except the flat appearance of the feet, whereby there is little to no arch visible when standing.
Children with symptomatic flat feet may experience or display one or more of the following symptoms:
- An outward tilt at the back of the heel
- Change in walking / gait pattern: clumsiness, limping after long walks
- Pain or tenderness in the foot, knees and / or hips
- Discomfort or difficulty in wearing shoes
- Withdrawing / non-participatory at physical activity
- Hypermobility – may present with significant rolling in of their feet
Treatment option is warranted if your child presents with symptomatic flat feet
- Activity modification: There may need to be a temporary decrease in activity level that causes foot pain. Some high impact and intensity activities should be avoided temporarily. Your child may also need to avoid prolonged periods of standing or walkle to maintain cardiovascular health.
- Physical therapy: Tight Achilles tendon may be a contributing factor to flat feet. However, it is usually treatable with specific stretching exercises to stretch the tight muscle and heel cord, as well as strengthen weak areas. This also helps with development of correct foot posture.
- Appropriate footwear: Your podiatrist will advise on proper footwear for kids with flatfeet, depending on their age.
- Orthotics / insole: A custom orthoses could help improve a child’s foot position and support structure, as well as improve function.
- Physical therapies such as low level laser therapy, dry needling, myofascial therapy could help alleviate and reduce flat feet symptoms.
- Surgery: Surgery is warranted for kids with severe and symptomatic flat feet, whom conservative management fails to reduce flat feet symptoms. The suitability of surgery depends on the severity and degree of the deformity, and the underlying cause of the kid’s conditioning.