Pediatric Flatfoot: When to Worry and When to Watch

Flatfoot is a common concern among parents, especially when their child’s feet appear to lack arches. But not all flatfoot cases require intervention. Pediatric flatfoot can be either a normal part of development or a sign of something that needs professional evaluation. Knowing the difference is key to ensuring your child’s long-term foot health. 

What Is Pediatric Flatfoot? 

Flatfoot, or pes planus, occurs when the arch of the foot is low or completely collapsed, making the entire sole touch the ground. In children, this condition often appears during early development as their bones, joints, and muscles are still forming. 

There are two main types of pediatric flatfoot: 

• Flexible Flatfoot: The arch appears when the child stands on tiptoe or sits but disappears when standing flat. This is the most common and often harmless. 
• Rigid Flatfoot: The arch is always absent, and the foot is stiff or painful. This may indicate an underlying problem. 
  
  

When Is Flatfoot Normal? 

In most cases, flatfoot in children under 6 is completely normal. As they grow, their arches often develop naturally without the need for treatment. 

Watchful waiting is appropriate if: 

• The child has no pain 
• They walk, run, and play normally 
• There’s no stiffness or imbalance 
• The flatfoot is flexible (arch appears when not bearing weight) 
  
  

When to Worry About Flatfoot 

Medical evaluation is recommended if you notice any of the following: 

• Foot or ankle pain (especially during or after activity) 
• Stiffness or limited foot mobility 
• Uneven wear on shoes 
• Walking problems (clumsiness, limping, or fatigue) 
• Family history of foot deformities 
• The flatfoot persists beyond age 6–8 

Ignoring these signs may lead to long-term issues such as joint misalignment, postural problems, or chronic pain. 

Diagnosis & Evaluation 

At Fowad Foot & Wound Clinic, our pediatric foot specialists conduct a thorough physical exam and, if needed, may use X-rays to assess the foot’s structure. We focus on distinguishing between harmless flexible flatfoot and more concerning rigid or symptomatic cases. 

Treatment Options 

Most cases of flexible flatfoot do not require treatment. However, if intervention is needed, options may include: 

• Orthotic insoles to provide support and reduce fatigue 
• Supportive footwear with good arch and ankle support 
• Stretching & strengthening exercises 
• Physical therapy to improve gait and posture 
• In rare cases, surgical correction may be recommended for rigid or severely symptomatic flatfoot 
  
  

How Parents Can Help 

• Let your child walk barefoot on safe, uneven surfaces like grass or sand, it helps develop foot muscles. 
• Choose quality footwear that supports the arch and heel. 
• Monitor your child’s movement, pain levels, and wear a shoe regularly. 
• Schedule routine foot evaluations, especially if symptoms arise. 
  
  

Conclusion 

Pediatric flatfoot is often harmless and self-correcting, but not always. By knowing what to watch for and acting early when needed, you can ensure your child’s feet grow strong and healthy. If you’re unsure about your child’s foot development, Fowad Foot & Wound Clinic is here to help with expert, child-friendly care.