Flat Feet (Pes Planus)

Many adults and children have feet with flat or ‘fallen’ arches. The whole of their feet are in contact with the floor in standing, rather than the inside arch being raised. They are said to have ‘flat feet’ or ‘pes planus’.

It is quite normal for children under six years old have, or appear to have flat feet:

Babies have a ‘fat pad’ under the medial (inside) arches of their feet, which gives the appearance of a very flat foot. This fat pad is gradually absorbed in the first year.

When children first walk, they have a relatively wide base of support with their legs and feet turned out. The feet roll over, making them look flat. As balance improves during the second and third year, this posture starts to improve.

Most children develop an arch by five to six years of age

Some of the causes for flat feet, commonly seen by physiotherapists, include:

  • Tightness in the Achilles tendon (the thick tendon at the back of the heel). In order to get their heel down, a child will need to roll over (pronate) their foot.
  • Laxity (Looseness) in the Achilles tendon causes too much movement in the ankle joint and therefore the foot flattens
  • Core muscle weakness, if the muscles around the hips (especially the bottom) are weak this causes a change in posture around the hips and over pronation of the feet.

If an arch can be seen when your child stands on tip-toes, they have no back, hip, knee or foot pain and their coordination/ development is fine, there is generally no cause for concern.

However, because the feet of young children are soft and pliable, it is very important to look after them. If you have any doubts or your child is experiencing foot or leg pain, contact KidsPhysio for an appointment. Your physiotherapist will fully assess your child’s feet, muscle strength, posture and walking pattern and according to your child’s needs will:

  • Offer reassurance and advice on footwear
  • Provide exercises to stretch and/or strengthen muscles
  • Provide fun activities to help your child build up their foot muscles
  • Provide insoles to help your child’s foot and posture develop.
  • Arrange for your child to see an Orthotist or podiatrist
This little girl has very flat feet and wears insoles like these to help control her foot position.
This little girl has very flat feet and wears insoles like these to help control her foot position.
orthotic insole
Click here to download the KidsPhysio orthotic advice sheet.
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