Is it Normal for a Toddler to Have Flat Feet?

Every parent that has a painful flat foot is afraid that their child might inherit their foot type. It is normal for a child's foot to appear flat up to about the age of 2 due to a thick layer of baby fat that fills the arch area. As long as the child is otherwise healthy, and the foot is flexible and free of pain, then no treatment is necessary even if you think it may look "too flat" to be normal. Many times they actually inherited your spouses or grandparent's feet and got lucky!!

A child's arch becomes much more obvious around the age of 3 when that baby fat pad disappears. At this age it is still normal to see a "low" arch when standing, but their foot should have a good arch when sitting or lying down.

When a child has a severe flat foot, you will usually notice not only a low arch but an inward bowing of the inside of their ankle and their Achilles tendon. They look like they have a nice arch when non-weight bearing but it completely flattens out when standing. This is usually a flexible developmental flat foot and can lead to postural complaints, "growing pains" and poor muscle development.

In rare cases, some children are actually born with a malformation of the ankle bone that causes a rigid flat foot with the appearance of a "rocker-bottom" foot. These are usually evident within the first few months of life with a rigid foot.

If you are worried that your child has an inherited flat foot or is complaining  of foot and leg pain; time to visit the podiatrists at FAANT for an opinion. Contrary to popular belief, foot and leg pain in children is never normal; and most kids will not grow out of flat feet! There are simple changes in shoe gear and inserts as well as physcial therapy that may help your child run, jump and play with their friends without pain!

Does Your Child Have a Flat foot?

Parents are constantly asking me whether their child’s flat foot should be treated or if they will “grow out of it”.

This is one of the most controversial current topics in pediatric foot care and the debate is really over how to decide when treatment is warranted for pediatric flatfoot. The controversy rages most loudly when the flat foot in question is without pain. Many pediatricians tell parents that their child will indeed “grow out of it.” If this was true, why are we treating so many symptomatic flat feet in adults in our Grapevine, Texas office?

   It is easier to get agreement that a child with a symptomatic flatfoot should receive treatment. No one thinks a child in pain should be left untreated, especially given the myriad of options we have to relieve that pain. In that subgroup, the controversy is often over what type of treatment — off-the-shelf devices or custom orthotics — the child should receive.

The greater challenge for today’s podiatrist is having the ability to discern when treatment is necessary for children with painless flatfoot. Bear in mind that a painless flat foot does not imply an asymptomatic flat foot. Children often express their symptoms without reporting any pain. They may be lazy, frequently ask to be carried, prefer sedentary activities or have trouble keeping up with their peers. This can lead to childhood obesity issues and life long disability.

Only doctors who discuss these issues with the parents will uncover subtle manifestations of the flat, poorly supportive foot that are already contributing to changes in activity level and functional ability. The first step in identifying flat feet that require treatment is to uncover the subtle changes in activity level and performance that may well be caused or aggravated by foot misalignment and dysfunction. After one has started treatment, parents often report a significant change in children’s activity levels, which is often to the great satisfaction of the parent. The children themselves are happier, healthier and more active as well.

Powersteps had come out with a great pre-fabricated device that can get a symptomatic flat foot under control quickly. They are inexpensive and a great first line therapy for these children. They are also readily available at Healthy Steps! Some kids still need a custom functional orthotic, but at least we can get them on the road to recovery much quicker with these devices.

If your child has low arches or flat feet, bring them in for a biomechanical exam and ou doctors can talk to you more about the long reaching problems that can be avoided by treating their flat feet.

Children's Summer Shoe Tips

Summer means new ground for little feet to cover. Whether it's sand, water, dirt or grass, kids will be busy running, swimming, climbing and jumping.

Improper foot support can lead to aches, pains and sprains.

Shoes to avoid

As a mom with three girls, I know it's hard not to buy all of the cute shoes that are out for summer! However, in order to prevent tripping and maintain good contact with the footbed of the shoe to improve support, it is best to avoid flip-flop type of sandals unless they have a built in arch support..

Flip-flops as I have previously discussed in another blog, can lead to problems including stubbed toes, broken toes, blisters, arch and heel pain, tendinitis and sprained ankles.

Flip-flops do not offer kids enough protection or support for daily wear. They are fine for brief periods of time at the pool or beach. I see many children with foot pain after a long summer of walking barefoot or wearing unsupported sandals as well as injured toes and feet from sandals and flip-flops that lack protection.

Barefoot is not a good alternative. We live in a concrete jungle. Puncture wounds can really ruin a summer vacation!

Shoes to consider

There are better alternative to your traditional flip flop. Sport-style sandals offer more coverage and support than flip-flops and are also a better choice than open-toed sandals for balance and support.

Crocs can be an option if worn correctly. Crocs tend to be worn loose on the foot and therefore offer less support and stability. However, when they fit snug, they do offer good flex of the sole as well as being closed-toe and having a back strap.

Shoes for toddlers

Toddlers and new walkers, because at this stage in development flat feet are usually normal, do not need arch support from a shoe, but instead require a shoe that provides a substantial amount of flex to allow their feet to move freely.

Toddlers benefit from closed-toe shoes that are relatively close-fitting (don't allow a lot of wiggle room side to side). Open-toed shoes do not provide the amount of stability that a closed-toe shoe does. They are learning many new gross motor skills and require good support for all of the challenging new balance activities, as well as learning to walk in the grass, mulch or sand.

Shoes for older children

School-age kids need more support and cushioning, and flexibility at the ball of the foot from their shoes. Preteens and teenagers' feet are nearing maturity and for those who play sports will require sport-specific support from their shoes.

The right fit is essential

Once you've found the right shoe for your child's need, you need to find the right fit.

Because kids have feet that are slightly different in size, the larger foot should determine the shoe size. I recommend measuring the foot while your child is standing and allowing about a half-inch of growth room at the end of the shoe. You should allow one thumb width from the end of their toe to the end of the shoe.

Always use the store's measuring stick to obtain the length and width of their child's foot as a starting point to finding the right fit. The number may be irrelevant if the shoe company has sized them slightly off, but it is a good starting point. You may be amazed how much your child has grown!

Matching the right shoe to each summer activity is also important in protecting growing feet.

I recommend that children wear sneakers during the summer for daily walking, running and jumping. There are many lightweight, breathable and washable options, with proper heel cushioning, mid foot support, flexibility, good traction and rounded edges to decrease stumbles and falls. If you do want a sandal for summer heat and splashing in the water, choose a sneaker type sandal with cutouts and mesh - a much better choice than flat, non-cushioned flip-flops.

If your child is having trouble with their feet and you know the shoe fits and is correct for their activity, contact our office and we can take a look. Many children's foot problems are due to poor shoes, but gait problems can also occur. A short office visit may sort it out and get your child running, jumping and playing with the other kids, pain free, this summer!