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Ryan M. Putnam, MD
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Foot & Ankle
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Flat Feet and High Arches
What are flat feet?
Babies and toddlers appear to have flat feet when they are standing because their feet have fat pads. A slight arch may appear when the child sits or stands on tiptoes. Children are born this way; doctors refer to it as flexible flat foot. Usually it’s painless and doesn’t interfere with a child’s ability to walk or play sports. Most children outgrow it eventually as their feet get larger, their baby fat disappears and their foot muscles strengthen with weightbearing activity such as walking.
What signs indicate flat feet?
Although painless in young children, flat feet in older children and adolescents can cause an aching pain. Sometimes the pain only occurs during or after sports or other physical activity. Sometimes the child complains that his foot, ankle or leg is tired or that he has aching pain at night. If the Achilles tendon (at the back of the ankle) is involved, it may become red and painful. Sometimes there are calluses under the sagging arches.
When should you call a doctor?
Call an orthopaedic foot and ankle specialist if your child complains of foot pain, the ankle is red, the feet or ankles feel tired, or calluses are forming under the arches. Be sure to take your child’s shoes along to your appointment so the specialist can examine the pattern of wear. Adolescents who still have flat feet and complain of pain should also be evaluated.
What are treatment options?
Treatment may include stretching exercises to lengthen the heel cord. Your doctor may also recommend shoe inserts called orthotics. These custom-molded arches made of composite materials provide support and relieve pain. Shoe inserts not only help people with flat foot to walk comfortably, they also extend the life of their shoes, which otherwise would wear unevenly. In certain cases, physical therapy is recommended, and sometimes children are put in casts if the heel cords are too tight. In a few cases where other treatments don’t relieve pain, surgery is recommended.
The tendency to have flat feet runs in families, although there can be other causes as well. It can’t be prevented.
Heel cord stretch
Stand three feet from the wall with your feet pointed straight ahead. Lower your hips to the wall without raising your heels off the floor. Hold for five seconds. Repeat three to six times.
Just as feet with low arches can cause problems, so can feet with high arches. A high arch, which is also called a cavus foot, is sometimes seen in children but may not be noticed until adulthood. As with flat feet, high arches sometimes are hereditary. People with high arches are vulnerable to overuse injuries during sports and exercise because their feet aren’t good shock absorbers. Not as much of the foot touches the ground to provide support for walking.
Custom-molded shoe inserts are prescribed for high arches. The inserts position the foot properly and provide shock absorption.
The American Orthopaedic Foot & Ankle Society (AOFAS) , https://footcaremd.org/conditions-treatments#conditions
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