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.

Can You Get a Infection From Going Barefoot?

Yes! Going barefoot can lead to puncture wounds, foot infections, fungus, warts and all kinds of nasty things if you aren't careful. Watch this child discuss her foot pain with her teacher who gives her good advice about protecting her feet from nasty dirty floors at school!

Is Your Child Hiding Their Foot Pain?

Children often hide their foot pain. Is your child having this conversation in the locker room with their friends? Ask them! Relief for childhood foot pain is right around the corner at Foot and Ankle Associates of North Texas in Grapevine, TX. For more go to www.faant.com or call (817)416-6155. Listen in on this conversation.....

Kids Have Foot Pain Too!

School is barely in session and already my Grapevine office is overrun with kids. Lots and lots of kids! We joked Wednesday afternoon that I think I saw the entire 4th, 5th, and 6th grade in one afternoon. It really did seem that every patient that day was around 10 years old! As I was giggling with another patient, who thought she had mistakenly walked into a pediatrician's office, she really made me aware that most adults don't realize that kids have foot issues. She asked why they were all there and what kinds of things kids come in with, then laughingly suggested that they couldn't all have ingrown toenails!

After I stopped laughing, I thought I would enlighten my readers on the kinds of problems kids have with their feet. In fact, if you happen to have kids, a great way to educate yourself and them is to ask for a copy of our free coloring book with fun bunny pictures and lots of information about childhood foot issues. Here is a good summary to tide you through until you get your free coloring book.

Kids have foot pain just like adults, but because of their rapidly growing bones and tendons, they often have confusing symptoms and need to be treated in different ways.

Some kids are just born with, to put it simply, jacked up feet. Arches that are really high (caves feet) or practically non-existent (flat feet or calcaneal valgus) are common, with varying symptoms. Some kids walk and run really strange, often tripping and falling. Some kids have severe problems fitting shoes or wearing them out rapidly. Many kids experience "growing pains" or cramps in their feet and lower legs - these are never normal despite what many pediatrician's are taught to believe. Heavier kids have more foot related issues, but skinny kids have foot pain too.

Kids with abnormal feet and gait issues often suffer from traveling pains and overuse sports injuries.

The most common is calcaneal apophysitis, a.k.a. Sever's disease, a.k.a. pediatric heel pain. These kids have pain in their growth plate that worsens with activity. I saw a lot of this in the last few days due to early season football and soccer. The cleats and the increases activity are the beginning of the perfect storm of pediatric heel pain. Add to that the love of barefoot and flip flops, we have an early Fall epidemic of heel pain. The good news is that pediatric heel pain is often pretty easy to treat if you focus on the cause, improper biomechanics, or simply said, jacked up feet.

Other common foot type related ailments seen in kids are posterior tibial tendinitis (pain and swelling in the largest tendon that holds up your arch), Achilles tendinitis (pain in the largest tendon on the back of your heel), shin splints (pain in the front of your shin bone or lower legs), and Osgood-schlatter's disease (pain and swelling in the growth plate just below your knee). These are also treated primarily by realigning the biomechanics of the child's foot.

Kids with gait issues may in-toe or out-toe causing muscle and joint imbalances. Some kids are even chronic toe walkers. These types of issues can be foot type related or can be caused by some underlying nerve issues. Orthotics (shoe inserts to balance abnormal foot function) and physical therapy are usually very helpful.
Of course, kids also can suffer from traumatic sprains and strains as well as stress fractures and fractures. No one is immune to fall down and go boom!

What else do we see in kids? Lots and lots of ingrown toenails and pesky warts. Skin and nail issues are abundant and seem to be ignored all summer long. I implore all parents to take a look at their kid's feet and nails. Little problems become big headaches when not addressed. A simple ingrown toenail can become a huge abscess when picked at repeatedly by your child.

So while I replenish my kids treat drawer and balloon stash, remember that kids have lots of foot issues too and at Foot and Ankle Associates of North Texas, we treat lots of kids! Request a free coloring book for your kids and don't ignore their feet!

PS. Just so Moms and Dads don't feel left out, we have a free book for you too. Just request a copy of Got Feet for yourselves. No pictures to color, but lots of great information!