Should I be worried if my child has flat feet?

St. Joseph’s/Candler Podiatrist Dr. Prianka Sharma addresses stages of flat foot and treatment options

Have you ever taken a good look at your feet or your child’s feet? Most probably seem pretty normal. However, there’s a large population of youth and adult Americans who have a condition called flat foot, or officially known as pes planus. For some, it never bothers them, but others may experience a lifetime of foot pain unless they seek treatment.

Flat foot is a condition in which the arch of the foot collapses and the entire sole of the foot completely or nearly completely touches the ground upon standing. The arch falls when tendons in the foot get stretched out and do not pull properly together, resulting in little or no arch. The specific tendon that is responsible for keeping your arch elevated is the posterior tibial tendon, says Dr. Prianka Sharma, a podiatrist with St. Joseph’s/Candler Physician Network – Podiatry.

Flat foot is mostly a hereditary condition. However, other factors may cause flat feet including obesity, trauma and some health conditions such as rheumatoid arthritis and diabetes.

“A flat foot in children is usually a congenital issue,” Dr. Sharma says. “Most children are asymptomatic, and it is often their parents who discover it.”

In infants and toddlers, the arches of the feet haven’t developed yet, so if your two-year-old is walking around and it looks like they have flat feet, that’s normal. Most children outgrow pediatric flat feet. However, for those that don’t, especially if they are in pain, seeking treatment is also normal and recommended.

“If we can get children with flat feet in proper support and shoe gear, they can have a relatively normal life and pretty much do what they want to do,” Dr. Sharma says. “In a way, we can help mold the foot with orthotics because it is still growing and still flexible.”

However, if it goes untreated, what was once flexible becomes rigid.

“If your child is flat footed, it’s not the end of the world, especially if they are not complaining of symptoms,” Dr. Sharma says. “But at the same time, that doesn’t mean we can ignore it. This is, unfortunately, a progressive issue if you leave it untreated. We can catch it and prevent the progression.”

Surgery is rarely needed but is a long-term option, once your child is old enough.

“If a child is not reacting well to orthotic inserts, for example, we can consider surgery,” Dr. Sharma says. “That would be done down the road when the patient is skeletally mature.”

Flat foot in adults

Adults also experience flat feet, which can develop in middle-aged and older adults, often due to normal aging. The Institute for Preventive Foot Health estimates more than 26 million adults have flat feet or falling arches.

“Like all tendons in our body, the posterior tibial tendon can become degenerated over time,” Dr. Sharma says. “Obese patients are more at risk, and women experience it more frequently than men, usually due to the fluctuation of weight during pregnancy.”

The degree of flat feet is based on stages. There are four stages. Stage one and two typically can be treated outside of surgery. Here’s a look at the stages.

• Stage 1: A patient may experience pain along the heel, arch or ankle but there is minimal deformity or collapsing of the arch. Treatment options include orthotics, inserts and proper shoe gear.
• Stage 2: The collapsing of the arch is more noticeable and patients are likely to experience weakness in the arch and pain. However, the foot is still flexible. Minimally-invasive soft tissue procedures can help repair damage and control pain.
• Stage 3: The deformity has progressed to the point where the foot becomes rigid and will no longer come back to a normal foot. This requires soft tissue repair and reconstruction surgery of the arch.
• Stage 4: In addition to a completely collapsed, rigid arch, deformity in the ankle begins, requiring surgery for both the foot and ankle.

“Whatever your daily activities have been, with flat feet they can now cause fatigue,” Dr. Sharma says. “Plus, a lot of force goes through the ankle when you are walking. So ankle pain can be an issue as well, then it goes up to the knee and so on.”

Problems with your feet? You can schedule an appointment with Dr. Sharma online or call 912-354-3668.