If you’ve noticed that your child’s feet look flat when they stand, you’re far from alone in wondering whether it’s something to be concerned about. Flat feet, also called pes planus, are one of the most common reasons parents visit a paediatric orthopaedic specialist. The good news is that in the vast majority of cases, they are a completely normal part of childhood development.
Why flat feet are so common in children
Almost all babies are born with flat feet. The arch of the foot develops gradually as children grow, typically becoming visible between the ages of 3 and 6. Some children simply take longer than others, and up to the age of 8 to 10, flat feet are generally considered a normal developmental variant. Studies suggest that around 40% of children aged 3 to 6 have flat feet, with the prevalence decreasing naturally with age.
When to seek a specialist opinion
Most cases of childhood flat feet resolve on their own and require no treatment. However, there are situations where a specialist assessment is advisable. These include when your child complains of persistent pain in the feet, ankles, knees or lower back; when they fatigue more easily than their peers during physical activity; when their shoes wear down unevenly; or when the flat foot is rigid rather than flexible, meaning the arch doesn’t appear even when the child stands on tiptoe.
What treatment looks like
When treatment is recommended, it ranges from conservative approaches such as orthotics or physiotherapy, to minimally invasive surgical options for cases that don’t respond to conservative management. One of the most common surgical techniques is calcaneal arthroereisis, a short procedure performed in day surgery, where a small implant is placed to support the natural alignment of the foot. Many children are walking again within a day of the procedure and return to sport within 4 to 8 weeks.
Questions to ask your specialist
If you’re attending a first appointment with a paediatric orthopaedic surgeon, it helps to come prepared. Ask whether your child’s flat feet are flexible or rigid, what the recommended approach is and why, what the timeline looks like, and what to expect in terms of activity restrictions during recovery.
The most important thing
Don’t self-diagnose or delay a consultation if your child is in pain or showing signs of difficulty with physical activity. An early assessment gives you the most options, and in many cases, the reassurance that no treatment is needed at all.
References: Pfeiffer M et al. “Prevalence of flat foot in preschool-aged children.” Pediatrics, 2006 · American Academy of Orthopaedic Surgeons (AAOS), aaos.org · Carr JB et al. “Pediatric Flat Foot.” Pediatric Annals, 2016.
