The Flat Feet in Children Controversy

Flat feet in children are a controversial topic among health professionals. The debate centers around if it needs to be treated or left alone as many of them grow out of it. Flat feet or a lower arch is a really common finding in toddlers and young children. Most of them do grow out of it and never have any problems. Some do not grow out of it and eventually develop problems. The debate is around should they all be treated to make sure that they do grow out it and if this over treatment is warranted. Parents are obviously concerned about the appearance of the foot and do not want problems to develop for their child in the future.

What is obvious is that it should be treated if it is painful or causing symptoms. These symptoms may not be just pain but could be things like increased frequency of tripping. Those who are at a higher risk of developing problems probably also be treated. These would probably include those who have a particularly severe flat foot and those whose both parents have flat feet and have problems.

What is not so obvious is the treatment, if any, that is needed for those children with flat feet that do not meet those criteria. Should they be treated based on the low probability that they will not grow out of it and become a problem. Different health professionals will make different arguments that they should and that they should not. Some of these arguments from both sides of this debate are often made passionately and with a lot of conviction. Unfortunately, the current state of the evidence to guide this is not that good and a lot more research is needed to guide this.

For those that do need to be treated there are a number of options. For some it may just need to be some simple padding added into the footwear which is easy and inexpensive. For others a prefabricated type foot orthotic can be used. If the problems are more complex then a custom made foot orthotic may occasionally be necessary. These interventions will need to be periodically replaced as the child grows. Alongside these types of treatments it is probably a good idea that exercises be used to strengthen the muscles that support the arch of the foot and help with coordination and normal development.

An episode of the Podiatry related livestream and podcast, PodChatLive did an episode on the controversy with the hosts chatting with the podiatrist, Helen Banwell. They addressed the issues of symptomatic versus asymptomatic flatfoot in children and discussed the topic of when it needs to be treated versus when it does not need to be treated. They also discussed the possible importance of asking about family history and how to deal with worried and anxious parents. Obviously, a lot more research is needed on flat feet in children to determine just which ones should be treated and what the best treatment for that is.

Craig Payne is a University lecturer, runner, cynic, researcher, skeptic, forum admin, woo basher, clinician, rabble-rouser, blogger and a dad.