Flat Feet in Children: When to Worry and When Not To

Flat feet in children is a common concern among parents, especially when they start noticing their child’s arch (or lack of one) while barefoot or buying new shoes. The good news is, most cases of flat feet in young children are normal and require no treatment at all. But sometimes, flat feet can lead to pain, fatigue, or difficulty keeping up with peers, and that’s when a podiatry assessment becomes worthwhile.

At My Family Podiatry, we assess children of all ages and help families understand what is and isn’t normal when it comes to their child’s foot development. Here’s what every parent should know.

What Are Flat Feet?

Flat feet, or “pes planus,” refers to a foot that has a lowered or absent arch, causing the entire sole to make contact with the ground when standing. It’s important to know that flat feet are very common in young children. In fact, most babies are born with flat feet and do not develop visible arches until around the age of six.

There are two main types of flat feet:

• Flexible flat feet: The arch is present when the child is sitting or standing on tiptoes but flattens when they stand normally. This is the most common type and is usually not a cause for concern unless there are symptoms.

  
  

• Rigid flat feet: The arch is always absent, even when the child is non-weight bearing. This type is less common and can sometimes be associated with underlying structural or neurological conditions.

  
  

When Flat Feet Are Normal

Flat feet are often just part of normal development. Children’s bones, ligaments, and muscles are still maturing, and many will naturally develop an arch by the time they reach school age. If your child has flat feet but is otherwise active, pain-free, and able to run, jump, and keep up with other kids, it’s likely nothing to worry about.

Flexible flat feet without symptoms do not require treatment. There is no evidence that trying to “build an arch” using special shoes or orthotics in these cases will change foot structure as a child grows.

When Flat Feet Might Be a Problem

There are some instances where flat feet can lead to symptoms or be a sign of an underlying issue. Some red flags that may indicate a need for professional assessment include:

• Pain in the feet, ankles, knees, or legs during or after activity

  
  

• Fatigue or early tiring during sports or physical play

  
  

• Difficulty keeping up with other children

  
  

• Tripping or clumsiness

  
  

• Frequent complaints of sore feet

  
  

• Uneven shoe wear, especially excessive wear on the inside edge

  
  

• Reluctance to participate in sport or physical activity

  
  

If your child has flat feet and any of these signs, it’s worth booking a podiatry appointment to explore further.

Conditions Associated with Flat Feet in Children

In some cases, flat feet can be linked with other conditions that contribute to discomfort or poor biomechanics. These include:

1. Joint Hypermobility

Many children with flat feet also have hypermobile joints, meaning their joints move more than usual. While flexibility is not inherently bad, excessive ligament stretchiness can place more strain on the muscles and soft tissues of the lower leg and foot. These children often fatigue more quickly and may complain of aching feet and legs, particularly after school or sport.

We often see hypermobility contributing to symptoms like “growing pains” and night-time leg cramps. Management may involve supportive footwear, stretching routines, or prefabricated or custom orthotics depending on the severity of symptoms.

2. Sever’s Disease (Heel Pain)

Flat feet can contribute to uneven forces at the back of the heel, where the Achilles tendon inserts. This can aggravate the growth plate in the heel and cause a condition known as Sever’s disease. This is most common between the ages of 8-14 years of age. Children may limp or avoid weight bearing on one side, especially after sports and activities. Early treatment involves managing load, reducing inflammation, and addressing any underlying biomechanical contributors like flat feet.

3. Knock Knees or Internal Rotation

Some children with flat feet also present with inward-turning knees or feet. This can result in increased clumsiness, tripping and even pain along the outside leg muscles due to the extra load.

What About Growing Pains?

Growing pains are common in children, but persistent or severe pain is not normal. Children waking at night with aching legs, or constantly complaining of foot and leg pain, should be properly assessed. These symptoms are often dismissed as “just growing pains,” but they may indicate something else, including flat feet or hypermobility causing muscle overuse.

At My Family Podiatry, we take a thorough look at the child’s foot posture, range of motion, activity levels, and muscular control to determine whether intervention is needed.

How We Can Help at My Family Podiatry

We take a comprehensive approach to children’s foot assessments. This includes:

• Reviewing foot and lower leg posture

  
  

• Checking joint flexibility and muscle strength

  
  

• Watching how your child walks and runs

  
  

• Discussing footwear, activity levels, and symptoms

  
  

• Providing recommendations tailored to your child’s needs

  
  

For children who do require intervention, treatment may include:

Orthotics

Depending on the child’s presentation, we may recommend either custom orthotics or prefabricated orthotic devices. These are used to support the foot, the arch and reduce excess strain on muscles and joints. We will always explain our reasoning and ensure parents understand the differences and benefits of each option.

Footwear Advice

Supportive, well-fitted shoes can make a big difference in how flat feet function day to day. We help parents understand what to look for in school shoes, sport shoes, and casual footwear to reduce discomfort and improve performance.

Strengthening and Stretching

We often recommend home-based exercises to improve foot strength and flexibility. For hypermobile children, specific strengthening routines may also be helpful to reduce fatigue and pain.

Activity Modification and Load Management

If pain is linked to a sudden increase in activity (like a new sport), we may recommend modifying how or how often your child trains. In some cases, relative rest is needed to allow inflamed tissues to settle before returning to full activity.

Supporting All Children

We have experience working with children of all ages and needs, including those who are neurodivergent or have difficulty in clinical environments. We understand that every child is different and tailor our approach to ensure they feel safe, supported, and comfortable during their visit.

Quick Checklist: Should My Child See a Podiatrist?

If your child has any of the following, it’s time to book an appointment:

✅ Flat feet with pain or fatigue

✅ Wakes at night with leg or foot pain

✅ Struggles to keep up with other children

✅ Frequently trips or appears clumsy

✅ Complains of sore feet after school or sport

✅ Wears out shoes unevenly

✅ History of growing pains that don’t improve

✅ You just want peace of mind

Final Thoughts

Most flat feet in children are completely normal and require no treatment. But if your child is in pain, feeling limited in their activity, or you simply want reassurance, we’re here to help.

A proper assessment can give you clarity, address any concerns, and help your child stay active and happy. Our goal is always to provide practical solutions and the least invasive treatment options to get your child back to doing what they love.

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