$Unique_ID{PAR00074}
$Pretitle{}
$Title{Medical Advice:  Flatfoot}
$Subtitle{}
$Author{
Editors of Consumer Guide
Chasnoff, Ira J}
$Subject{Flatfoot arch arches feet soles worn shoes brief exercise foot pain
flat-footed tiptoe orthopedic shoe Thomas heels scaphoid pads}
$Log{}

Your Child:  A Medical Guide


Flatfoot


     Quick Reference

     SYMPTOMS
     - No arches in the feet
     - Entire soles of the feet rest on the ground
     - Walking on the inner edges of the feet
     - Tops of the shoes broken down from the inside
     - Worn inner edges of the heels and soles of shoes
     - Pain in the feet after brief exercise

     HOME CARE
     - If a child past the age of three years seems flat-footed, have the
       child tiptoe barefoot for five to ten minutes a day.
     - If a child over six to eight years old seems flat-footed, have the
       child walk barefoot on the outer edges of the feet with the toes
       clenched for ten minutes a day.

     PRECAUTIONS
     - Don't be concerned if your young child seems flat-footed.  All infants
       and toddlers have flatfoot to some degree.  The arches are not fully
       developed until children are three or four years old.
     - Toddlers should not wear walking shoes until they can walk unaided on
       hard surfaces.
     - If a child under three or four years old wears out the inner edges or
       the upper portions of his shoes before the shoes are outgrown, buy
       shoes of a style with a strong counter (the inner part of the back
       third section of the upper shoe).
     - Do not use orthopedic shoes or devices without competent professional
       advice.  Orthopedic shoes and devices may actually harm normal feet.
     - Pain in the feet after excessive use and exercise is normal.


     Flatfoot is a condition in which the arches of the feet are flattened so
that the entire sole of the foot touches the ground.
     A normal newborn baby does not have arches in the feet.  (The normal
condition of a child's feet before arches develop is sometimes called
"physiological flatfoot.")  Arches don't start to develop until the child
begins to walk unaided.  They are not fully formed until the child is three to
four years old.  Arches are formed by the exertion of forces by the developing
leg muscles on the bones and ligaments of the feet.

SIGNS AND SYMPTOMS

     With true flatfoot, there are no arches when a child stands.  The child
walks on the inner edges of the feet.  This practice breaks down the tops of
the shoes from the inside and wears down the inner edges of the heels and
soles of the shoes.  The child may complain of painful feet after brief
exercise.
     The presence or absence of an arch at any age can best be judged when a
child stands on the tips of the toes.  After age three or four, your child
should no longer wear out the inner edges of the shoes.

HOME CARE

     To encourage development of the feet, children should not wear walking
shoes until they start to walk unaided on hard surfaces.  If a child under
three or four years of age breaks down the upper portions of the shoes or
wears out the inner edges of the heels before the shoes are outgrown, buy
shoes with a stronger counter.  If your child past age three appears
flat-footed, have the child tiptoe barefoot five to ten minutes per day.  A
child over six to eight years of age should walk barefoot on the outer edges
of the feet with the toes clenched for ten minutes daily.

PRECAUTIONS

  -  Do not use orthopedic shoes or devices without competent professional
     advice.  Thomas heels, scaphoid pads ("cookies"), and orthopedic shoes
     are expensive if not needed, and they may actually harm normal feet.
  -  Pain in the feet after excessive use and exercise is not abnormal.

MEDICAL TREATMENT

     Your doctor will examine your child's feet carefully while the child
stands, sits, stands on tiptoes, and walks.  The doctor will conduct tests of
the movement of the foot joints, the strength of the foot muscles, and the
strength of the tendons.  Worn shoes will also be examined.  Rarely will x-ray
examination of the feet be ordered.  After considering these factors, as well
as the child's age, the doctor may prescribe exercises or orthopedic shoes.