“My daughter/son has flat feet and I am concerned and would like to get it checked out. Maybe they need orthotics?”
This is a statement and question we hear often at SoleFit from concerned parents. Certainly a sensible question, especially in modern society where prevention is often percieved as such a valuable strategy. So how does a parent know when to be concerned about the health and development of their children’s feet?
We’d like to offer some suggestions to guide the parent to know what to do in these situations:
Ask your pediatrician at annual visits from an early age if you have any concerns with the development of your child’s foot or if you think it’s hindering them in any way. Young children’s feet are expected to be highly flexible and as a result are usually flat (45% in children 6 years and younger and 15% with 6-10 year olds). A slow developing or abnormal foot type is recognizable and your paediatrician can evaluate this to determine if a specialist is required to examine things further. A non-symptomatic (pain free) scenario where a foot is flat or seemingly abnormal is generally no cause for concern but best to ask the question for your own piece of mind.
Links to some published journal articles regarding treatment and assessment of a flat footed child are offered below:
If your child is complaining of pain, especially in the foot, lower leg or during periods of activity or weight bearing, best to have it assessed. Children can become injured in the same way as adults and it’s important to have things looked at to determine the causes. A child’s foot may directly or indirectly play a role in this and pain is a good indicator to check it out. Start with a physician or with a specialist (Pedorthist, Physiotherapist, Chiropodist, etc.).
Prevent abnormal development of the foot by supplying the right type of shoes. The initial 6-7 years of a child’s life mark the period where their feet will go through the most transformation and require proper development. The child’s foot will critically assist as they learn to balance, walk, run, and coordinate. A child’s shoe should not hinder these natural functions by being overly rigid, supportive, or corrective (unless recommended to treat a problem). Shoes should be flexible, thin, and anatomically fitted to the natural shape of their feet and keep the child’s foot close to the ground. This strategy should be implemented as much as possible into adolescence. The exceptions are specific footwear such as cleats, skates, ski boots, etc. A thorough video is linked below to Podiatrist Dr. Ray McClanahan suggestions of how to evaluate for children’s footwear.
Arch supports/foot orthoses for children should come as a last consideration. Unless to specifically address dealing with pain caused by overuse, juvenile arthritis, rigid congenital deformities, and juvenile osteochondrosis, an arch support for children should not generally be used. If a child’s foot or associated condition is not responding to treatment or is recurrent, an orthotic may be recommended for the short term to assist fixing the issue. In many cases, custom orthotics are not required (unless it’s an irregular foot type) in which case an over the counter arch support will often be sufficient. Arch support can however often prove beneficial in irregular footwear that impedes normal function such as dance shoes, cleats, ski boots, cycling shoes, etc.
At SoleFit our goal when assessing children is to look for the short and long term solutions to deal with problems. This often will include parent education of footwear selection along with factors to consider for flexibility, strength and coordination to improve the development and/or rehabilitation of the child’s foot. If arch supports are recommended or required we can offer over the counter options along with specific custom orthotics when needed. Plans for the length of time they might be required are discussed to ensure the best outcome while allowing the foot to continue to mature with natural function.