Flat Feet in Children

Flt feet are a common cause of pains in the joints and muscles of the legs

Parents frequently present in our clinic with children who they believe have flat feet. In a lot of these cases the child has already been elsewhere and has either been given insoles or orthotics, or have bought an over the counter pair of insoles.

In a lot of these cases the child will have been given an unsuitable pair of insoles or orthotics. When this happens we reassess and try where possible to adjust the pair of devices they have to suit rather than starting with a new pair. We also do a full biomechanical assessment and not just look at the feet, as any orthotic or insole is going to change the mechanics of the entire body.

When we are assessing a child we look at a number of things

  • The birth history and early development.
  • The position of the child’s feet on the floor.
  • The position of knees, hips, back, neck and shoulders.
  • The overall flexibility of the muscles.
  • The strength of various muscles.
  • The movement within the feet.
  • The alignment of the joints in movement.
  • The ability of the child to do specific simple tasks.
  • The gait, how the child walks and runs.

This allows us to accurately assess if the child has flat feet, high arches or other biomechanical deviations, and the impact of these on the body.

During this assessment we also identify potential issues which may arise in the future because of the biomechanics that the child has had. These include conditions such as Oosgoold Schlatters, Chondromalacia patella, Severs or Sinding-Larsen-Johansson.

When the risk of these conditions is identified, with early intervention, we can frequently prevent the onset of these potentially sports limiting conditions.

Why do flat feet occur in children?

Feet are considered flat when:flat feet can cause biomechanical deviations throughout the body which can cause alignment related joint and muscle pains

  1. The heel bone does not sit upright on the floor but tilts inwards. This usually results in the arch of the foot looking flat as it falls in.
  2. The arch of the foot is collapsed without the heel falling in. People sometimes mistake a fallen arch for a flat foot.

Supinated feet occur whenAsupinated foot is known as Pes cavus and as it has lost its shock absorbency it can lead to other problems

  1. The heel bone is tilted outward and the arch is higher than normal
  2. The plantar fascia of sole of the foot is taut and raising the heel bone at the back.

Parents always ask why their child has flat feet or high arches:

There are various contributing factors to a presentation of flat feet or high arches?

  1. hereditary from family
  2. Tight calf muscle and so the foot is pulled inwards to gain mobility as the child tries to walk
  3. The ligaments in the foot are lax and the foot collapses
  4. The Tibialis Posterior muscle which supports the longitudinal arch of the foot is weak
  5. The ligaments and small intrinsic muscles of the feet are under working.
  6. The plantar fascia in the sole of the foot is tightened or shortened.

What is the treatment for flat feet?

In our clinic we will do a detailed biomechanical assessment of the child, as described above, to determine what biomechanical issues in the child have caused any problems.

From this, we will determine what biomechanical deviations within the child may have predisposed to his flat feet. We will analyse our findings to determine the exact cause of the flat feet.

Our treatment of flat feet will be determined by the assessment findings but generally include some or all of the following:

It is our policy to follow children through until they are 16 years of age. We feel we should follow up on children whom we give orthotics to as we are effectively changing the position of the child’s body and so we should monitor them.

By doing this detailed biomechanical assessment we are effectively changing your child, for the better, and potentially for life. We have several children who were on the verge of giving up sport because they felt they were no good, or were in pain, and are now actively participating teenagers.

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