Flat Feet in Children: When to Seek Treatment and Guidance

Flatfoot issues in children?

Hello Doctor: My child is almost four years old and has had a slight outward turning of the feet since birth.
This condition persists now that he is four.
Recently, I took him to a general orthopedic clinic, and the doctor diagnosed him with flat feet and recommended corrective measures.
However, I have significant doubts about the correction based on my online research.
My child's situation is as follows: both feet have arches, but when viewed from behind, the ankles and the soles do not align in a straight line; instead, they form an "L" shape typical of flat feet.
He has no issues walking or running.
In terms of stamina, there was a period when he complained of leg fatigue and refused to walk, but now he can walk the entire time at the aquarium and the zoo without any complaints of fatigue.
I have read that children's muscle development is not yet complete, and some suggest sitting cross-legged as a form of adjustment.
However, I am concerned about missing the critical period for correction.
Should I consult a rehabilitation specialist directly, or should I see an orthopedic doctor?

min mami, 20~29 year old female. Ask Date: 2009/07/27

Dr. Lai Yanting reply Rehabilitation

Based on your description, your child likely has physiological flatfoot (it is recommended to have a professional physician confirm this).
The condition is caused by ligament laxity and typically only presents as flatfoot when weight-bearing.
Most children with this condition do not exhibit significant symptoms and generally do not require special treatment.
However, if there are recurrent tendonitis or foot pain, the use of orthotic insoles may be considered for improvement.
It is advisable to consult a pediatric orthopedic specialist directly.
Thank you for your inquiry!

Reply Date: 2009/07/27

More Info

Flat feet, or pes planus, is a common condition in children where the arches of the feet are either absent or not fully developed. This can lead to a variety of symptoms, including discomfort or pain, particularly during physical activities. In your case, your child has been diagnosed with flat feet, and you have some concerns regarding the need for treatment and the best course of action.

First, it’s important to understand that flat feet are quite common in young children. Many children are born with flat feet, and as they grow, their arches may develop naturally. In fact, it is not unusual for children under the age of 5 to have flat feet, as their foot structures are still developing. The arches of the feet typically begin to form between the ages of 2 and 6, and by the time children reach adolescence, most will have developed normal arches.

In your situation, since your child is almost four years old and has been diagnosed with flat feet, it’s essential to monitor the condition closely. The fact that your child is able to walk and run without significant issues and has shown improvement in stamina is a positive sign. However, the presence of discomfort, such as the complaints of "sore feet," should not be overlooked, as it may indicate that the flat feet are causing some biomechanical issues.

Regarding treatment, the approach can vary based on the severity of the flat feet and the symptoms presented. If your child is asymptomatic and does not experience pain or functional limitations, many healthcare providers may recommend a watchful waiting approach. This means monitoring the condition over time to see if the arches develop naturally as your child grows.
If your child does experience pain or if the flat feet are causing issues with walking or running, treatment options may include:
1. Orthotic Devices: Custom or over-the-counter arch supports can help provide additional support to the foot and alleviate discomfort. These devices can be particularly beneficial if your child is experiencing pain during activities.

2. Physical Therapy: A physical therapist can work with your child to strengthen the muscles in the feet and legs, which may help improve arch development and overall foot function. Exercises that focus on balance, flexibility, and strength can be beneficial.

3. Footwear: Ensuring your child wears supportive shoes that fit well is crucial. Avoiding flat shoes or flip-flops that do not provide arch support can help manage symptoms.

4. Activity Modification: If certain activities exacerbate your child's discomfort, it may be advisable to limit those activities until the symptoms improve.

As for your question about whether to see a rehabilitation specialist or an orthopedic doctor, it may be beneficial to start with a pediatric orthopedic specialist. They can provide a comprehensive evaluation of your child's foot structure and function and recommend appropriate treatment options. If necessary, they may refer you to a physical therapist for further management.

In conclusion, while flat feet can be a concern, many children outgrow the condition without any intervention. However, if your child is experiencing pain or functional limitations, seeking further evaluation and treatment is advisable. Monitoring your child's development and ensuring they have the right support can help manage any potential issues related to flat feet.

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