The Next Step Difference: Child Flat Foot


Your Child has flat feet: Why you should choose Next Step Foot and Ankle Clinic.

Flat feet in children is a dynamic process.  Flat feet can change over time as the child develops.  This is well documented in medical literature. But as a rule of thumb, if you’re child has reached the age of 7 and still has a significant flat foot, there is probably something wrong.  This is especially true if someone else in the family has flat feet.


Orthotics DO NOT improve the structure of a flat foot:

Most other clinics will recommend some type of arch support or orthotic as a primary treatment for flat feet.  Oftentimes, a simple over-the-counter arch support can be helpful to some degree. However, these treatments do not affect the long-term outcome of flat feet.  The feet will remain flat and generally do not heal into a corrected position.

The European Journal of Physical and Rehabilitation Medicine published a review article in 2011.  This article reviewed 146 articles reviewing thousands of patients on the efficacy of different treatments for flat feet.  The title was: A Review of the Evidence for Nonsurgical Interventions for Flexible Pediatric Flatfeet. The article found that NO evidence indicates that orthopedic footwear or foot orthosis immediately improve the radiographic parameters in children with flexible flat feet.  In other words it makes little difference if you wear orthotics or arch supports or not. The studies which evaluated the effective interventions on radiographic parameters over time found no significant difference between those who used arch supports or orthotics and those who didn’t.  The foot essentially remains the same.  


Flat Feet:  A Major Problem for Kids

The first thing most parents notice when their children have flat feet is that they have a great deal of difficulty keeping up with their peers.  When they participate in sports, the parents notice that the child “runs funny”. Also, the child seems to tire easily in most cases. Many times the chief complaint is the patient is unable to go to the mall or Sea World or any other place that requires prolonged walking without wanting to sit down every 30 minutes.  The children generally do not complain of pain.   They complain of getting tired.  Flat feet are also associated with increased knee pain and cartilage erosion of the knees later in life.  Hip pain and back pain are also associated with flat feet. What I have observed in 30 years of the practice of medicine is just a gradual decreasing quality of life for children with flat feet.  They become less and less active and as a result they generally gain weight. They become video game players and just avoid activities that would otherwise keep them healthy. It’s not that they’re lazy.  It’s that it’s difficult for them to pursue normal activities that are not problematic for children with normal feet.


Children DO NOT Outgrow Flat Feet

Every week in our clinic we have a patient come in as an adult who has had flat feet since childhood.  They usually have seen well intentioned doctors who have provided arch supports or orthotics. They are miserable.  They have arthritis in their feet and knees. They cannot be on their feet for long periods. Exercise is usually out of the question.  It is hard for them to play with their children or go places with their families because of the pain in their feet and ankles. Fixing the feet as an adult is often much more difficult and requires more recovery time.  Frequently this is not possible because of financial concerns and being off work once the patient reaches adulthood and its associated responsibilities.


Surgical Intervention Required

Of course, we use orthotics and arch supports when appropriate.  They’re certainly not a bad idea. But with the understanding that these devices in the long run do not change the foot, we also offer surgical intervention. 

At Next Step Foot and Ankle Clinic we can provide treatment options that can correct flatfeet and make a huge difference in the lives of our patients.  We have done flat foot reconstructive surgery for many years.  Some of these procedures are minimally invasive and require just a couple of weeks in a cast.  The incision for this type of surgery is less than half an inch. Other surgeries are more structural in nature and require a few weeks of non-weight bearing.  We have helped 100’s of children increase their quality of life, their tolerance to and enjoyment of activity, and their foot alignment by selecting the right surgical procedure for each individual patient.   If surgery is needed, being able to select the right procedure for the patient is critical.

Flat feet can be a major problem for kids.  Many people (some doctors included) think it is just something you have to live with.  This is not the case. So if you think your child is struggling with flat feet give us a call and let us discuss which options might be best for you.  

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