Flat Feet in Children: When to Watch and When to Act

Many parents notice their child’s feet appear “flat” and worry that something may be wrong. The reassuring news is that flat feet are very common in childhood and, in many cases, are part of normal development.

What do we mean by “flat feet”?

When a child stands, the arch on the inside of the foot may look low or appear to touch the ground. This is especially common in younger children due to natural flexibility, developing soft tissues, and typical growth patterns.

As children grow, arches often become more visible. Some children continue to have a lower arch into adolescence and adulthood without any pain or functional problems.

When is flatfoot a concern?

Flat feet are worth assessing when they are associated with symptoms or functional changes, such as:

  • pain in the feet or legs

  • fatigue or avoidance of walking or running

  • frequent tripping or clumsiness

  • stiffness or reduced movement in the foot

  • a noticeable difference between the two feet

How a child functions and feels is far more important than how the feet look.

What does current evidence suggest?

Research and clinical guidance indicate that:

  • flexible flat feet are common in children and are often a normal variation

  • treatment is not recommended for flat feet that are painless and not affecting activity

  • when symptoms such as pain, fatigue, or reduced participation are present, conservative strategies may help

  • orthoses do not permanently change bone structure in flexible flat feet, but may improve comfort and function in selected cases

Management decisions are guided by symptoms rather than appearance alone.

How we assess flat feet

A podiatry assessment typically looks at:

  • walking and running patterns

  • joint mobility and muscle strength

  • balance and functional tasks

  • how the arch behaves during movement

  • footwear fit and wear patterns

The focus is on how the foot works during everyday activities, not just how it appears when standing still.

Management options

When support is needed, management may include:

  • temporary activity adjustments to manage pain or fatigue

  • strengthening of foot and ankle muscles

  • footwear advice to improve comfort and support

  • orthoses when clinically appropriate, particularly if symptoms affect daily activity

Orthoses are used selectively and reviewed periodically as your child grows.

What parents can do

  • choose supportive, well-fitting shoes

  • encourage varied movement and active play

  • monitor for pain, fatigue, or changes in participation

When to seek help

It’s helpful to seek professional advice if your child:

  • has ongoing pain

  • avoids walking, running, or sport

  • trips frequently

  • has one foot behaving very differently from the other

This information is general in nature and is not a substitute for individual assessment, diagnosis, or medical advice from a qualified health professional.

Sources
The Royal Children’s Hospital Melbourne – Kids Health Info: Flat feet
NHS UK – Flat feet in children
Evans AM, Rome K. A review of paediatric flatfoot and management approaches (summary evidence)
Australian Podiatry Association – Consumer foot health resources
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