What is pediatric flatfoot?

Pediatric flatfoot refers to several conditions that have one feature in common—a complete or partial collapse of the foot’s arch. The more serious forms of the condition—called “rigid” flatfoot—are tarsal coalition and vertical talus.

Flexible flatfoot is the term used when the foot’s arch shrinks or disappears upon standing but reappears upon sitting or standing on tiptoes. The condition is considered to be a variation of normal because the foot has normal muscle function and good joint mobility. Most children with flexible flatfoot outgrow the condition as they grow and walk more. Walking helps the foot’s soft tissues to tighten, which in turn gradually shapes the arch.

What are the symptoms of flexible flatfoot?

Although most children with flexible flatfoot do not have symptoms, some do experience aching pain along the bottom of the foot. A doctor should be consulted if a child’s flatfeet cause pain.

How is flexible flatfoot diagnosed?

The first step is to rule out the more serious rigid flatfoot conditions. To do this, the doctor may ask your child to sit, stand, raise the toes while standing, and stand on tiptoe. The doctor also may examine your child’s heel cord (Achilles tendon) for tightness and the bottom of the foot for calluses. He or she also may examine patterns of wear on your child’s everyday shoes. Since this condition is sometimes inherited, it is important to let the doctor know if anyone else in your family is flatfooted. It is also important for the doctor to know if your child is known to have a neurological or muscular disease.

What is the treatment for flexible flatfoot?

Treatment is only required if your child is experiencing discomfort. This can include:

  • Stretching exercises for the heel cord for activity-related pain or tiredness in the foot/ankle or leg.
  • Shoe inserts that act as arch supports to relieve foot pain and fatigue. These may also extend the life of your child’s shoes if they wear unevenly.
  • Physical therapy or casting if your child has flexible flatfoot with tight heel cords.
  • Surgical treatment may be needed for an adolescent with persistent pain.

Instead of correcting with growth, a small number of flexible flatfeet become rigid. These cases may need further medical evaluation.

For more information about flexible flatfoot and its treatment at St. Louis Children’s Hospital, contact us at 314.454.5437 or 800.678.5437 or email us.