Flatfeet in children is a common condition as their bones and joints are still immensely flexible at a young age and their tendons take time to form an arch. While parents tend to worry about the abnormally low or absent arches in their children’s feet, it is usually not a cause for concern since most will eventually outgrow the problem. As children grow and walk more, the soft tissues along the bottom of the feet tighten and shape the arch.
If your child’s flatfeet are not causing any pain or discomfort, treatment is oftentimes not required. But if flatfeet persist even after your child has entered adolescence, they may experience other symptoms like calf, feet or back pain which can affect their quality of life.
When that happens, it is advisable to bring your child to an orthopaedic specialist for an accurate diagnosis and treatment. Read on to find out more.
Signs and symptoms of flatfeet in children
Children above 5 years old who have yet to outgrow their flatfeet may experience pain and stiffness after strenuous activities, trip and fall easily, have unbalanced shoulders, and walk with an unusual gait. Additionally, they may also feel pain when wearing shoes and have difficulty moving their feet from side to side and up to down.
Thus, it is important to bring your child to a doctor if he or she is suffering from any of the symptoms mentioned above. Early intervention is the key to preventing complications, such as scoliosis and bunions from forming.
Complications when flatfeet are left untreated
Although there has been no evidence to show that flatfeet lead to the development of scoliosis (curved spine), these conditions can coexist especially when the shoulders become imbalanced, affecting the legs, pelvis and vertebrae.
An abnormally low arch may also cause bunions to develop as the improper structure of the feet results in poor alignment of the toes.
Furthermore, damage to the important tendon in the inner feet can cause adult acquired flatfeet to develop, leading to permanent deformity and the inability to stand on tiptoes.
In some cases, children with flatfeet may have an underlying medical condition such as a tarsal coalition (an abnormal connection between two or more bones in the back of the foot) or unstable navicular (unfused bones since birth) that will require further evaluation.
Diagnosing flatfeet in children
At the orthopaedic specialist’s clinic, the doctor will examine your child’s feet for calluses and heel cords for any tightness. These will help the doctor determine whether your child is suffering from flatfeet.
Further diagnostic tests may be required too, such as weight-bearing feet or long-leg standing x-ray to assess the alignment of the feet and diagnose abnormalities causing pain. These x-ray images will make for a more accurate diagnosis and determine the severity of your child’s flatfeet to suggest the appropriate treatments.
Treatment options for flatfeet in children
Conservative treatments are usually recommended and necessary only if your child is experiencing discomfort.
The orthopaedic specialist may suggest wearing shoe inserts that can be either soft, firm or hard-moulded to relieve pain and fatigue on your child’s feet. This treatment method works 90% of the time and most patients experience an improvement in symptoms after wearing shoe inserts.
Your child may also be asked to practise stretching exercises that will help to relieve pain in the feet, ankles and legs. Stretches are also recommended if your child has a shortened Achilles tendon.
Changing footwear is also an option, as supportive shoes are more comfortable than footwear with minimal support. While this will not correct flatfeet, it can provide day-to-day relief and prevent further damage.
When conservative treatments prove to be ineffective, the doctor may suggest a minimally invasive surgery called Extraosseous Tarsal Tunnel Stabilisation (EOTTS). It involves placing a titanium stent through a 1.5cm small incision into the natural space between the ankle and heel bones to realign and stabilise the feet, and support the arch until the growth is completed. Most patients are able to return to normal activity without the need for special shoes or insoles after the surgery.
Speak to an orthopaedic specialist today
Although most flatfeet cases in children are not serious, it is still advisable to get them assessed by an orthopaedic doctor as timely intervention is key to preventing worse symptoms or damage.
If your child is suffering from flatfeet and the symptoms mentioned, do not hesitate to bring him or her to an orthopaedic specialist as soon as possible.
Dr Kannan Kaliyaperumal is experienced in treating a range of orthopaedic conditions, including flatfeet in children, to help patients get back to doing what they love.