Flat Feet - FAQs

Flatfeet are very common in children under the age of three and most are variations of normal. Usually the foot isn’t really flat; rather the instep hasn’t developed because of some residual “baby fat”. The condition can also persist due to ligamentous laxity (double-joints) and/or out-turned feet. As the medial longtitudinal arch of the foot has ligaments along with muscles and joints supporting it, the arch tends to collapse due to body weight on weight bearing, in such ‘loose-jointed’ children. Arch is visible once the child goes on tippie-toes.

Flat Feet

Bilateral flexible and painless flat-feet do not require treatment. Studies have shown that no ‘special shoes’ or any particular shoe inserts help in forming the arch and thus are unnecessary. Children may be left barefoot at home as there is no evidence that shoes help them to walk better. Soft, flexible-soled leather shoes would be great for outdoors.

On the other hand, if flat-feet in children are not supple, if the condition is painful or if it involves only one foot, this would require further imaging and investigations. Use of shoe-inserts are justified under these circumstances. Surgical management is almost never required in a child and may be considered only in a symptomatic adolescent.

Tarsal coalitions which are relatively uncommon, can lead to rigid painful flatfeet warranting surgery. Certain cases of accessory navicular which can result in painful flatfeet, can benefit From surgery.

Dr Ramani Narasimhan
Senior Consultant, Pediatric Orthopaedic Surgeon