This website uses cookies to give you the best experience. By continuing to use this website you are consenting to cookies being used. You can delete and block cookies from within your browsers settings. For more information please refer to our privacy and cookie policy page.

Continue

Flat Feet

When are flat feet normal? 

  • Normal in babies and toddlers, usually resolves by 6 years of age as the longitudinal arch develops.
  • They persist in at least 10% of children, commonly are found with other features of hypermobility and are often familial (check parents feet !!).
  • Management involves explanation, reassurance, and advice regarding appropriate supportive footwear (i.e., supportive heel cup and mid-foot support with fastened laces).
  • Physiotherapists, orthotists and podiatrists may provide exercises and insoles if problems persist.

Photo: Flat feet in a healthy 4 year old - normal arches form when standing on tip-toe - (mobile flat feet). Note that the changes are symmetrical.

 flat feet

When are flat feet not normal? 

  • Absent arch when child stands on tip-toes (non-mobile flat feet). 
  • Asymmetrical changes (i.e., one foot fixed and flat). 
  • Evidence of pressure on the foot such as blistering / callosities.
  • Swelling or stiffness of joints.
  • Limping or persistent pain.
  • In teenagers with a fixed/painful flat foot, think of Tarsal Coalition (a condition where bones in the foot are joined together). 
  • Inflammatory Arthritis can also cause a painful stiff flat foot. Radiographs can be normal. Referral is required for further investigation. 

The indications for referral are:

  • Joint stiffness or swelling. 
  • Absence of arch on tip-toe.
  • Signs of pressure (e.g., blistering).
  • Persistent pain.
  • Limp or symptoms interfering with function (sport/play).
  • Systemic features. 

Referral is advised to rheumatology or orthopaedics. Conditions to consider are: 

  • Inflammatory Arthritis – joints are stiff, warm or swollen (often the midfoot). 
  • Tarsal Coalition – joints fixed and painful on walking and weight bearing. 

Photo: Stiff Flat Foot due to Inflammatory Arthritis (Juvenile Idiopathic Arthritis).

stiff flat foot due to inflammatory arthritis



Site Statistics

To date (end of May 2022) PMM has >1,086,978 hits and >454,640 users from 223 countries!

Short online courses

from Newcastle University, UK

e-resources from PMM

pmm for you

Please help us ensure pmm is as useful to you as possible by completing this short survey

complete survey