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Paediatric flat foot (pes planus)

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What is it?

This is often the term used to describe the shape of a foot when the “arch” which runs down the inside of the foot (heel to big toe) sits in a low position, touches the floor or appears “flat”.

People often observe that this looks like the feet are collapsing and knees are falling or rolling inwards too.

Children between the age of 1-5 usually do have flat feet and this is perfectly normal. The “arches” usually form as they begin to mature, but this can take some years. Roughly 95% of children will grow out of their flat feet and of those that don’t only a small proportion usually have pains or issues.

How can I help myself?

Unless your child is in pain, there may not be much you need to do. Monitoring their development is important though.

Ensure your child has correctly fitting shoes with adequate support or structure for the activities they are taking part in.

As the foot develops it is also important, if it is safe and appropriate, that they should spend time running and walking barefoot (for example at home) as well as spending time in shoes.

When to see a Podiatrist?

If your child has pain in their feet or pains related to their walking or running, or if they are struggling with mobility or keeping up with other children their age, then this is when you should seek help and get an assessment.

A podiatrist will take a thorough history (including birth history and developmental milestones) and discuss the history of pain or problems. The physical exam might include watching your child walk and run and checking range of motion of the hips, knees, ankles, and feet. They may also check muscle tightness, nerve / muscle function, and coordination.

If they are concerned they may order x-rays or refer your child to an orthopaedic/paediatric specialist.

If your child is pain free but you are concerned about the shape of their feet then often the podiatrist will suggest a “watch and wait” approach and maybe give some simple exercises.

Foot orthoses (insoles to go in their shoes) may also be given which can help to reduce pain and other problems.

Flat foot
Flat foot
Flat foot