Question 1

My child has flat feet but no pain - do they need orthotics or special shoes?

Accepted Answer

No. If your child has no pain and can run, jump, and play normally, they do NOT need orthotics or special shoes. This is the most important message for parents. Flexible flatfeet in children are extremely common (up to 20% of kids) and most are a normal developmental variant that improves naturally as the child grows. Strong research evidence, including Cochrane Reviews and multiple randomized trials, shows that orthotics do NOT change the natural history of flatfeet, do NOT create permanent arches, do NOT prevent flatfeet persisting into adulthood, and do NOT prevent future foot problems. Orthotics only provide symptom relief if pain is present. For asymptomatic flatfeet, observation alone is appropriate - your child can wear any comfortable, supportive athletic shoes (no need for expensive specialized footwear or custom orthotics). Studies following children for 10+ years show those who had orthotics and those who had no treatment have identical outcomes. Save your money and avoid medicalizing a normal variant.

Question 2

Will my child's flat feet cause problems when they're older?

Accepted Answer

Probably not. Large population studies show that adults who had flatfeet as children have the same rates of foot pain and disability as adults who had normal arches as children. Having flatfeet as a child does NOT predispose to arthritis, chronic pain, or functional limitations in adulthood in the vast majority of cases. About 20-30% of children with flatfeet will continue to have flatfeet as adults, but most of these adults remain asymptomatic. A small percentage (estimated 5-10%) of people with severe flatfeet may develop progressive posterior tibial tendon dysfunction in middle age (40s-50s), causing acquired adult flatfoot deformity with pain and disability—but this condition also occurs in people who had normal arches as children, so childhood flatfeet aren't necessarily predictive. The key message: if your child has no pain now, they're unlikely to develop pain in the future regardless of arch height. Focus on maintaining healthy weight, staying active, and building strong, resilient feet through regular physical activity rather than worrying about arch appearance.

Question 3

How can I tell if my child's flatfeet need treatment or are just normal?

Accepted Answer

Ask yourself two questions: (1) Does my child have pain? (2) Is my child able to run, jump, and participate in activities normally? If the answers are 'no pain' and 'yes, normal activities,' then your child's flatfeet are a normal variant requiring no treatment - just observation. Red flags that warrant doctor evaluation include: pain with activities (foot aching after walking or sports), rigid flatfoot (arch doesn't appear when child stands on tiptoes - suggests possible tarsal coalition or other pathology requiring investigation), asymmetry (one foot much flatter than the other), progressive deformity (getting worse over time rather than improving), or functional impairment (child avoiding activities, limping, frequently tripping). The 'Jack test' you can do at home: have your child stand barefoot and observe the arch (or lack thereof), then have them stand on tiptoes - if arch appears on tiptoes, this confirms flexible flatfoot which is benign. If arch never appears even on tiptoes, see a doctor as this suggests rigid flatfoot. Most importantly, trust your child's symptoms over appearance - painless flatfeet that don't limit activities need no intervention.

Medical Disclaimer

Flat Feet in Children (Flexible Flatfoot)

📖What is Flat Feet in Children (Flexible Flatfoot)?

🔬What Causes It?

⚠️Risk Factors

You may be at higher risk if:

🛡️Prevention