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What is “flat foot”?
Q: I would like to find out more about "flat foot." I took my 2½-year-old son to a free screening at a chiropractic centre and the doctor told me that my son is flat-footed. He said I have the option of sending my son for therapy twice a month and he will need to use special chiropractic insoles, which are quite expensive.
A: Aezlynda, many parents are concerned about their young children’s feet because they look so different from older children’s and adults’ feet. It’s normal for young children to have feet that appear flat—this is because their arch is hidden by a fat pad, and their feet bones and joints are very flexible so their feet flatten out when they stand up. Over time, as children lose their fat pads and their bones and joints become less flexible, you begin to see the arches in their feet. This usually happens by the time children are 6 years old.

Even after 6 years of age, about 10-20% of children continue to have flat feet. Although we used to think that flat feet caused problems and that special exercises, shoe inserts and shoes were necessary, we’ve found that is only rarely true. Most children with flat feet never develop foot problems and no treatment is necessary as long as their feet remain flexible and walking/running is comfortable. Although some podiatrists and chiropractors may recommend special exercises, insoles, and shoes, most doctors believe that these do not help develop the arch in children’s feet. Usually children with flat feet do fine as long as you get them well-fitting, supportive shoes.

Only a small proportion of children with flat feet have a problem diagnosed when their feet and ankles aren’t flexible enough, they have foot pain or problems walking or running. Talk with your son’s doctor about this—he can examine your son’s feet for flexibility by moving them up and down, side to side, and twisting; and watch your son walk and run. If the doctor thinks your son might have a problem, he would refer him to a pediatric orthopedist for evaluation and treatment if necessary.
Karen Sokal-Gutierrez M.D., M.P.H. Pediatrician