This last week seemed to be children’s flatfeet week in the office. I saw kids from 2 years old to 18 years old whose parents wondered if they needed to do anything or not for treatment. We’ve all seen the toddler whose feet are flat as pancakes. Little Johnny doesn’t walk right and his feet turn out, should I buy better shoes? Well, there is no right or wrong answer.
There are two different philosophies to treating flatfeet in kids. One, the pediatrician philosophy, is that they will grow out of it, and the arch will be normal. The other philosophy, treat the flatfeet with some kind of arch support and try to shape the arch around the arch support, or orthotic. When a child begins to walk around 9-15 months, the foot has a chubby appearance, and there is less boney structure to the feet. At this point, it’s hard to determine if any future problems could arise. When they are 2-3 is when the foot starts to begin to shape because the bones are starting to form.
When is treatment necessary? I guess I’m conservative when deciding to treat or not. If the child is having pain in his feet, ankles, hips, and/or back, then I recommend treating it. If the child is just flatfooted with no pain, then I don’t treat. On the other hand, what’s wrong with treating it if there isn’t pain? Nothing!! At least between myself and the parents we are being proactive. I have seen many kids who I put into a support, and as they get older, the arch begins to look better. Now is it normal development or is it the arch support? I don’t know. No one knows, but it’s better than being passive and not treating at all. There is nothing to lose, and there isn’t any harm done wearing the orthotics. It never hurts to at least have the child’s feet examined by a podiatrist to determine if treatment is necessary or not.