Flatfeet in Children

A problem in the tissues and bones of the feet can cause flat feet. For some young children, flat feet may be common and not a cause for concern as the feet are still growing and developing. As they age, the tendons should slowly tighten to form an arch in the foot. If the tendons fail to tighten, this could result in permanent flat feet in children that may last into adulthood. This then begets the question – when is it the right time to have your little one visit a healthcare professional to treat flat feet? It is recommended for children with flat feet to consult a doctor once they are five years of age and experience pain and stiffness in their foot, have a broad or played foot or find themselves in the habit of tripping and falling.

When it comes to flat feet in children in Singapore, it may be symptomatic or asymptomatic. Symptomatic flat feet revolve around the appearance of the foot or certain outcomes due to having flat feet. These include little to no visible foot arch, outward tilt at the heel, pain or discomfort from the feet to the knee or difficulty putting on shoes. Asymptomatic flat feet can be more challenging to navigate as the child experiences no symptoms from their flat feet. Should your child experience any of the above symptoms, it is highly advisable to consult an orthopedic surgeon.

In non-serious cases, flat feet in children may occur as the tendons in their feet are still developing. Apart from developmental factors, other causes include cerebral palsy, muscular dystrophy, juvenile arthritis, inherited disorders and connective tissue disorders. Such causes can interrupt the interaction between the bones, ligaments, muscles and nerves in the foot, which enable proper, structural development. The result is a collapsed arch – the most visibly common symptom of flat feet. While the above causes cannot be controlled, one controllable cause is obesity. Obesity may increase pressure on the foot, thus, collapsing the arches.

While the above causes can be controlled and minimised, there are biological risk factors as well that can increase one’s risk of Achilles tendonitis including age, gender and physical traits. Achilles tendonitis is found to occur in men more than women and its risk increases as each individual ages. With regards to physical traits, those with a naturally flat arch in their foot are more prone to experiencing Achilles tendonitis due to the extra pressure placed on the Achilles tendon.

Prevention is always better than cure and there are certain measures parents can take to lower their child’s risk of flat feet in Singapore. For one, supportive shoes are a great option. Attributes of a supportive shoe include a stiff middle, flexible toes and a rounded heel for greater support and contact with the ground. This helps to properly structure children’s feet and strengthen the muscles for effortless and comfortable mobility. Encouraging a proper foot structure is crucial, especially in a child’s developing years.

Stretching exercises may also minimise the risk of flat feet in children. Focus on exercises that stretch the Achilles tendon. One of which is to sit in a chair and lift the feet such that only the heel touches the ground. Pull the big toe back away from the floor and repeat it two to four times, several times a day. Finally, ensure your child is of healthy weight to prevent them from exerting extra weight on their feet. A healthy diet and plenty of exercises are the way to go!

Ultimately, the treatment options depend on your child’s condition and the doctor’s recommendation. In less severe cases, non-surgical treatments may be sufficient. Your doctor may recommend arch supports. These custom-made orthotic devices are fitted into your child’s shoes to alleviate pain and help reduce flat feet symptoms. Parents can choose to get them over the counter or have them customised to their child’s feet. Alternatively, your doctor could also advise physical therapy as a treatment option. Physical therapy involves exercises that can help strengthen your child’s feet and provides education on how they can better manage flat feet and minimise injuries.

Typically, surgery is the last resort when treating flat feet in Singapore. However, it may be necessary in serious cases that persist into adulthood. In flat foot correction surgery, a 1.5cm keyhole incision is made in the outer foot and a stent is inserted to promote arch growth. Children should be able to return to normal activities after 2 weeks of rest.