Flat feet?

Q: My son seems to have really flat feet. And he trips a lot. Would special shoes help him?

A: A flat foot refers to a condition in which the arch of the foot disappears or diminishes when a person stands. Most often, the arch will reappear if the person is sitting or standing on the tiptoes. Almost all babies and young infants are initially flat footed as the muscles and soft tissues in their feet are just developing the strength associated with standing and walking.

In older children (around age 8 or older) and adults, if the arch continues to be flat with standing, but reappears with the change in position (sitting or standing tip-toe), this is called a flexible flat foot. If the arch doesn’t reappear with sitting or standing on the tiptoes, this is called a rigid flat foot. 

If a flat-footed child doesn’t have any associated symptoms, most often a physician will recommend a “watch and wait” approach. Other than the appearance of the foot/feet, this condition should not limit movement or prevent a child from fully participating in any sports or physical activities. 

If a child does have symptoms — which can include foot or leg pain, tenderness and/or cramping, heels that tilt/turn greatly outward (or greatly inward), a change in the manner of walking, or pain or discomfort while walking — then your physician may recommend further evaluation. 

An evaluation may include imaging and/or a referral to a physical or occupational therapist or orthopedic physician. 

Shoe inserts may be considered. Inserts typically can be placed into regular shoes, so special shoes are generally not needed. 

If you’re worried your son’s flat feet are interfering with his mobility and balance, be sure to discuss these concerns with your child’s physician.

Dr. Kimara Gustafson is a Minneapolis mother who works as a pediatrician at Masonic Children’s Hospital and the Adoption Medicine Clinic, both at the University of Minnesota. Send your questions to kgustafson@mnparent.com.