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It’s normal for babies and toddlers to have flat feet. But contrary to popular belief, it’s not always something all children will simply outgrow.

If you’ve noticed flat feet in your children, here’s what you need to know.

What Does It Mean to Have Flat Feet?

Flat feet in children are also known as over pronation or pes planus. Pediatric flatfoot means that the foot lacks a normal arch when standing.

Most children with flat feet have what’s known as flexible flat feet. That means they have a normal arch in their feet when they aren’t bearing weight on them. But when they put weight on their feet, the arch disappears.

Pediatric flatfoot can be classified as either symptomatic or asymptomatic. If children have pain with activity, it is considered symptomatic. Having flat feet can affect the body’s alignment. This can cause your child to have pain in their ankles, knees, and back. If no symptoms exist, then the flatfoot is considered asymptomatic.

What Causes Flat Feet in Children?

As your child grows, their arch develops with tendons, ligaments, and bones of the foot. The process takes place during the toddler years, around two or three years old. By age 10, most children usually develop an arch, according to the U.S. National Library of Medicine.

Flat feet can be hereditary; however, some children never develop an arch because of a structural deformity in one or both feet.

Inherited connective tissue disorders that cause loose tendons can lead to flat feet in children. These include Ehlers-Danlos syndrome (EDS) and Marfan syndrome. Both conditions are extremely rare.

Injury to the tendons can also cause flat feet even after the arches have formed. In this case, a flat foot can occur on only one side.

Obesity in children is significantly linked to arch collapse in early childhood. Other conditions that cause arches to drop include diabetes and rheumatoid arthritis.

Rarely, when children have painful flat feet, tarsal coalition is to blame, according to the U.S. National Library of Medicine. Tarsal coalition is a condition where two or more bones in the foot grow or fuse together. It’s one of several congenital foot deformities that can cause rigid flat feet.

How Are Flat Feet Diagnosed?

Your child’s doctor or pediatrician can diagnose flat feet. They’ll make a diagnosis by observing your child walking, standing, or running. And they’ll also do a physical exam and take a medical and symptom history of your child.

The doctor will also ask your child about their symptoms, including any pain or discomfort. If your child has pain, their doctor can order imaging tests to determine the underlying cause.

How Are Flat Feet Treated in Children?

If they’re not in pain, children often don’t require treatment for flat feet; however, if your child’s flat feet cause pain, there are treatment options available. Their doctor may prescribe orthotics to help relieve pain in their legs and back from being flat footed.

Over-the-counter medications can help with pain management. Just be sure to ask your doctor which OTC pain relievers and dose is right for your child.

Your child’s doctor may also prescribe stretching exercises and physical therapy to help prevent injury. If obesity is contributing to your child’s flat feet, their doctor may recommend a weight loss program. The goal of weight loss is to relieve the stress on your child’s feet.

If your child’s instance of flat feet is severe, their doctor may refer them to a podiatrist or orthopaedic surgeon specializing in foot and ankle surgery. Surgery is only necessary for symptomatic flatfeet that cannot be relieved with non-operative treatments, or if there’s an underlying injury to the tendon or bone.

To learn more or schedule an appointment with UPMC Orthopaedic Care, please call 1-866-987-6784 or visit our website.