Flat feet in children

As Podiatrists at Maidenhead Podiatry, we are often asked to look at the feet of young children as their parents ask – ‘My child has flat feet – do I need to worry?’.

All typically developing children are born with flexible flat feet. However, they progressively develop a medial longitudinal arch (the arch that runs down the inside of the foot) during the first decade of their lives.

While a child’s foot is expected to be flat, there is currently no consensus as to how flat this foot should be and while feet are seen to decrease in flatness with increasing age, it is not known how flat they should be at each any given age.

So, is it possible to define the postural characteristics, how flat is too flat and what is to be expected? What is a ‘typically’ developing paediatric (child’s) foot?

One way to is to compare all data currently published describing the typical development of the paediatric foot.

Looking at thirty-four epidemiological (incidence, distribution, and control) papers regarding the development of the paediatric foot, sixteen different common foot posture assessments were identified which used a footprint to measure the reported outcome.

What resulted were some interesting conclusions.

Firstly, the use of the term normal in relation to foot posture is misleading.

There is no such thing as normal in the categorisation of the paediatric foot, a flat foot posture is an expected finding at different ages.

Secondly, the foot posture of the developing child is indeed age-dependent and has been observed and demonstrated to change over time.

Therefore no firm conclusion can be reached as to which age the foot posture of children ceases to develop further because no two foot measures are comparable.

One of the problems with current research is that there is no consensus on how to measurement of the paediatric foot, using valid and reliable assessment tools.