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FLATFOOT IN CHILDREN

(ACQUIRED FLACCID FLAT FOOT)
Flatfoot in Children

WHAT YOU NEED TO KNOW:

What is flatfoot? Flatfoot, or fallen arches, is a condition that causes a lack of arch in your child's foot. Flatfoot is common in children younger than 6 years. It is normal for your baby not to have an arch that you can easily see. Babies have a fat pad that can cover the arch. You may be able to see the arch if you lift your baby so his feet dangle. The arch of the foot usually develops by 10 years, but your child may still have flatfoot as an adult. Flatfoot may be flexible or rigid. Flexible means your child has an arch when his foot is relaxed but not when he is standing. Rigid means his foot does not have an arch even when it is relaxed.

Foot Anatomy

What are the signs and symptoms of flatfoot?

  • The soles of your child's feet are flat on the floor when he stands

  • Your child's toes or heels point out as he walks

  • A tight Achilles tendon causes his heels to lift off the ground as he walks

  • Pain in your child's heel or arch that is worse when he moves his foot

  • Swelling on the inside part of your child's ankle

What increases my child's risk for flatfoot?

  • A family history of flatfoot

  • Obesity

  • An injury to your child's foot, ankle, or heel

  • A disease such as rheumatoid arthritis or diabetes

  • A condition such as cerebral palsy, spina bifida, or Marfan syndrome

How is flatfoot diagnosed and treated? Your child's healthcare provider will examine your child's feet and legs. He will ask about your child's symptoms, such as pain when he walks, and when they began. Tell him if your child had a recent foot or leg injury, or if anyone in his family has flatfoot. He may have your child stand with his feet on the floor, then on tiptoes. He may also watch your child walk to see how his feet are lined up. X-ray pictures may show how severe the flatfoot is and help guide treatment if needed. Treatment may only be needed if your child has symptoms such as pain:

  • A physical therapist can teach your child how to prevent overuse of muscles and tendons in his legs and feet. He can also teach your child exercises to stretch tight tendons in his heel. The stretches may be the only treatment your child needs.

  • Surgery may be needed if other treatments do not work. Your child may need to have a bone or tendon problem repaired. His ankle may be made more stable, or his Achilles tendon may be made longer. Bones may be fused (joined) or separated.

What can I do to manage flatfoot?

  • NSAID medicine such as ibuprofen can help relieve pain and swelling. Ask your child's healthcare provider how much medicine to give and how often to give it. Follow directions. NSAIDs can cause stomach bleeding or kidney damage if not taken correctly. If your child takes blood thinning medicine, always ask his healthcare provider if NSAIDs are safe for your child to take.

  • Rest can help relieve your child's pain. Do not let him do activities that make his symptoms worse. Ask your child's healthcare provider if sports are safe for your child.

  • Orthotics may be helpful if your child has foot pain. An orthotic is a device made of plastic that slips into your child's shoe. They support the arch as your child walks. Orthotics will not treat flatfoot or change how your child's foot develops as he grows. They will only help relieve pain and help your child walk more easily. Talk to your child's healthcare provider about the kind of orthotics that are best for your child. You might want to choose a style that is soft. Hard orthotics may increase your child's pain.

  • Shoes with flexible soles can help your child develop a normal foot motion as he walks. Ask his healthcare provider how old he should be to start wearing shoes.

  • Weight loss may help relieve your child's symptoms if he is overweight. A healthy weight can also prevent flatfoot. Ask your child's healthcare provider how much your child should weigh. He can help you create a healthy weight loss plan for your child.

When should I contact my child's healthcare provider?

  • Your child has new or worsening symptoms.

  • You have questions or concerns about your child's condition or care.

CARE AGREEMENT:

You have the right to help plan your child's care. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's caregivers to decide what care you want for your child.