Flatfoot

Flatfoot (pes planus) is a condition in which the arch of the foot disappears when a child stands, or when the entire sole of the child’s foot contacts the ground. In some cases, as the arch disappears, the child’s ankle also rolls inward (pronates).

There are two types of flatfoot:

• Flexible flatfoot: The most common form of flatfoot, flexible flatfoot affects both feet. It’s often a normal part of development (many children don’t develop arches until around age 10). Flexible flatfoot usually doesn’t cause pain or disability, and doesn’t require treatment.
• Rigid flatfoot: A rare type of flatfoot, rigid flatfoot affects both feet in roughly half of all cases. It often develops in children who have problems with the bones in their feet. Children who have rigid flatfoot might experience more severe symptoms, such as pain or cramping.

Conditions such as cerebral palsy or fused tarsal bones can cause abnormal development of the foot, leading to flatfoot problems.

While both flexible flatfoot and rigid flatfoot can cause symptoms, not all cases do so. In fact, most children who have flatfoot experience no symptoms. When children who have flatfoot do experience symptoms, some of the most common examples include:

• Changes in walking patterns (also known as gait).
• Heels that tilt outward.
• Cramping in the feet or legs.
• Pain or tenderness in the foot, ankle or lower leg when walking or during activity.
• Desire to withdraw from sports or physical activities that cause leg or feet pain.

At Gillette Children’s, we diagnose rigid flatfoot if we can’t find an arch when your child stands up on tiptoe or sits down. We also check for ease of movement in feet and ankle joints.

If your child has difficulty moving an ankle, for example, that symptom might point to a tight or shortened Achilles tendon. If they also experience pain, we might take X-rays to get a more detailed view of the foot.

If your child has flexible flatfoot with no pain, we don’t recommend treatment. However, if they do experience pain, we might recommend using an arch support in shoes. Arch supports don’t correct flatfoot, but they do provide additional comfort.

If your child has flexible flatfoot with a short Achilles tendon, we recommend stretching the tendon. Stretching can be part of a home exercise or physical therapy program.

In rare cases (typically with rigid flatfoot), a child experiences ongoing pain and tightness, even after other treatments. If this happens for your child, we might recommend surgery, but usually only for older children and adolescents.

If your child has flatfoot, internationally recognized orthopedic surgeons at Gillette work closely with you and your family to create a treatment plan that fits your child’s unique needs.

As part of that treatment, your child might see some of our experts in:

• Orthopedics.  
• Orthotics.
• Physical therapy.
• Radiology and imaging.

Your family can count on our team of specialists to treat complex conditions related to flatfoot. We welcome the involvement of primary care providers, teachers, and school and community therapists. Working together, we help your child feel their best.