Do children’s flat feet need treatment?

Children only need treatment for flat feet if they are experiencing pain, discomfort, or trouble walking and running. If your child has no pain, there is usually nothing to worry about. Many young children have flexible flatfoot—their arches disappear when standing but appear when sitting or on tiptoe. This is completely normal. Kids’ bones and tissues are still soft and flexible, and arches often don’t fully form until age 6 or older.

Signs that your child may need evaluation include:

• Tiring easily

• Avoiding physical activity

• Struggling to keep up with other children

• Complaining of foot or leg pain

Most kids won’t verbalize pain—they’ll just stop doing activities that bother them.

If your child is experiencing discomfort, bring them to our doctors at Next Step Foot & Ankle Clinic. There may be an underlying issue that needs attention. Request an appointment online or call 210-375-3318 to see us in Pleasanton or Universal City, TX.

Do I need surgery for flat feet? 

Flatfoot reconstruction is typically a last resort. Surgery is considered only when:

• The feet are painful

• Daily activities are affected

• Conservative treatments have failed

Noninvasive options—such as shoe changes, custom orthotics, and physical therapy—are always attempted first, usually over several months.

If low arches continue to cause significant pain, Dr. Darren Silvester and our team will evaluate your feet using diagnostic imaging and determine whether surgery may be beneficial. To schedule an appointment, call (210) 375-3318.

Why do the surgery at all for flat feet? 

Correcting flat feet in children can dramatically improve quality of life. After treatment, many kids:

• Become more active

• Enjoy running and outdoor play

• Experience less fatigue and discomfort

Flat feet are also linked to childhood obesity. Many overweight children have poor foot mechanics, and studies suggest over 50% may have flat feet. It’s often unclear whether obesity causes flat feet or flat feet contribute to inactivity—but both issues tend to feed into each other.

Flat feet can also lead to long-term pain in the feet, knees, and back. If your child is 7 or 8, avoids activity, or is overweight, try the wet footprint test. If you don’t see an arch—or see only a very small one—give us a call. Early evaluation can be a game changer.

What is the best age to consider surgery for flat feet? 

Once the diagnosis is confirmed, earlier is generally better.

At around age 7, bones are still soft and easier to correct. Early alignment helps the foot grow properly during key development years.
By age 16, the bones are nearly adult-like and much harder to reshape, often requiring more extensive procedures.

What types of surgeries are there for flat feet? 

While orthotics, braces, and arch supports can improve comfort, they cannot realign the bones.
Surgical procedures, however, can correct bone position and restore more normal function—often making a significant difference in a child’s daily life.

(If you’d like, I can list common surgical options like arthroeresis, tendon reconstruction, or osteotomies.)

What can be done about flat feet? 

Non-surgical options such as arch supports, custom orthotics, and braces can help with symptoms but won’t correct bone alignment.
Surgery is sometimes needed to rebuild proper structure and significantly improve function—especially in kids whose flat feet are painful or activity-limiting.

How do you get flat feet as a child? 

Most cases are hereditary. If parents or grandparents have flat feet—and often knee, hip, or back pain—it tends to run in the family.

Flat feet can lead to pain in several areas, including the heels, balls of the feet, and inside or outside of the ankles. In rare cases, injury may also contribute.

What is the problem with flat feet? 

Flat feet put the foot in a mechanically inefficient position, increasing stress on:

• Feet

• Knees

• Hips

• Lower back

These symptoms may take years to appear, but early signs in kids include:

• Avoiding running or “running funny”

• Difficulty keeping up with peers

• Fatigue during walks

• Preferring seated activities over active play

Children often won’t say “my feet hurt”—they’ll simply avoid what hurts.

Are flat feet in kids normal? 

Yes—and no.

Most children are born with flat, flexible feet and leave a full footprint until about age 3. After that, arches typically begin developing.

However, if a 7-year-old still shows a full wet footprint with little or no arch, it may be time for an evaluation. Many parents are told, “They’ll grow out of it,” but research shows that after ages 6–7, alignment usually does not improve significantly on its own.