Most kids with flat feet outgrow the condition
High fever was the concern, so as I walked over to my patient I was relieved to see that the 14-year-old was alert and in a cheerful, talkative mood.
I also noticed that she had been thoughtful enough to remove her wet shoes and carefully place them off to the side before jumping up on the exam table. I saw colorful inserts in the gym shoes and remembered that the girl had been using custom orthotics for a few years.
After I checked the girl's ears, throat and lungs, the teen mentioned that her knees had been bothering her. I moved down to do a careful exam of the knees to make sure there were no signs of joint inflammation linked to her febrile illness.
Mom soon joined in our discussion and reminded me that in the past the teen's flat feet had caused stress on her knees. The knee discomfort had resolved with use of orthotics but flared recently as the inserts wore down with repeated use. But not to worry, the mother assured me, her daughter had just seen her podiatrist and a new pair of orthotics was already on its way.
How common are flat feet or fallen arches in the pediatric population and how often do they cause trouble? Experts at the Oxford University Hospitals explain that most kids under five years of age have naturally flat feet.
Over 95 percent of flat-footers outgrow the condition and go on to develop normal arches. The other good news is that of the 5 percent who continue to be flat-footed as older children and adults, few will ever feel pain or be hampered by their lack of arches.
Most kids with flat feet have what is referred to as “flexible” flat feet (FFF). Feet appear flat when standing, but when the child goes up on tiptoes, an arch is seen along the inner sole of the raised foot. Rigid or stiff flat feet occur less commonly and require further evaluation.
The Oxford researchers caution that the use of special shoes, inserts, or splints will not change the foot shape or cause the flat foot to develop an arch. At the same time, inserts and arch supports can help some of the older kids who happen to experience pain due to their persistent flat feet.
On this side of the Atlantic, specialists at the American Academy of Orthopaedic Surgeons agree that FFF treatment is only indicated if the child has discomfort. Pain relief can often be achieved by performing heel cord stretching exercises and/or using soft, firm, or hard molded arch supports. Surgery is rarely needed.
Finally, in an article published in the journal Pediatrics, Dr. Anton Tudor and colleagues note that there is a common misperception that flat-footers demonstrate poor motor skills and therefore, inferior athletic performance. Their study of 11- to 15-year-olds shows no difference in a number of measures of athletic performance between groups of flexible flat-footers and their “normally” arched peers.
• Dr. Helen Minciotti is a mother of five and a pediatrician with a practice in Schaumburg. She formerly chaired the Department of Pediatrics at Northwest Community Hospital in Arlington Heights